[go: up one dir, main page]

WO1996003084A1 - Dispositif et procede de reconstitution de tissu connectif - Google Patents

Dispositif et procede de reconstitution de tissu connectif Download PDF

Info

Publication number
WO1996003084A1
WO1996003084A1 PCT/US1995/009417 US9509417W WO9603084A1 WO 1996003084 A1 WO1996003084 A1 WO 1996003084A1 US 9509417 W US9509417 W US 9509417W WO 9603084 A1 WO9603084 A1 WO 9603084A1
Authority
WO
WIPO (PCT)
Prior art keywords
sleeve
sheath
connective tissue
tissue
set forth
Prior art date
Application number
PCT/US1995/009417
Other languages
English (en)
Inventor
Ted Allen Conway
Edward A. Morra
Sebastian Paul Morra
Original Assignee
University Of Akron, The
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 University Of Akron, The filed Critical University Of Akron, The
Priority to AU31477/95A priority Critical patent/AU3147795A/en
Publication of WO1996003084A1 publication Critical patent/WO1996003084A1/fr

Links

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
    • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/04—Macromolecular materials
    • A61L31/06—Macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
    • 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
    • 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
    • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/02—Inorganic materials
    • A61L31/022—Metals or alloys
    • 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
    • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/04—Macromolecular materials
    • A61L31/043—Proteins; Polypeptides; Degradation products thereof
    • A61L31/044—Collagen
    • 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
    • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/04—Macromolecular materials
    • A61L31/048—Macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds

Definitions

  • This invention relates to a device and method for rejoining and/or bracing damaged connective tissue such as ligaments, tendons, muscles and the like. More particularly the invention relates to an extensible sleeve which will contract radially in response to axially applied tension so as to firmly grip portions of a connective tissue adjacent to damaged or severed tissue to redistribute relatively large tensile loads through the sleeve around the damaged tissue.
  • ACL severed anterior cruciate ligament
  • a common procedure for repairing a severed anterior cruciate ligament involves excising the damaged ACL and replacing it with a pros- thesis. After the damaged ACL is excised from the body, a hole is drilled through the femur and another hole is drilled through the front of the tibia.
  • the prosthesis is then threaded through the holes in the bones and attached at one end to the outside of the femur with a surgical screw, staple or other anchoring means, and the other end of the prosthesis is similarly anchored to the tibia.
  • the procedure is relatively intrusive and involves a considerable amount of trauma and discomfort to the patient.
  • the patient is generally provided with a bent knee case which immobilizes the joint for about 3 weeks during which time considerable atrophy occurs. Additionally, regrowth of tissue occurs in a randomly oriented manner which is not conducive to providing rapid restoration and rehabilitation.
  • syn ⁇ thetic prostheses generally have a limited useful life such as from about 4 to about 14 years,
  • patellar tendon graft technique Another common method of repairing a damaged ACL is the patellar tendon graft technique wherein the surgeon threads part of the patellar tendon through holes drilled in the bones. The surgeon first divides the patellar tendon into thirds and detaches the middle third from the tibia by peeling it back. The middle third of the patellar tendon is then inserted through a hole drilled in the femur, threaded through a hole drilled in the tibia and surgically anchored to the tibia surface.
  • This method has the advantage of utiliz ⁇ ing autogenous tissue, but generally has all of the other disadvantages associated with prosthetic ACL repair.
  • Suturing techniques are also often used to repair tendons. Suturing avoids the stiffness problem associated with the knotting technique, but prolonged immobilization and therapy are required to prevent the sutures from tearing through the connective tissues.
  • the tensile strength of connective tissue which has been sutured together is generally very low, such as about 20% or less of its normal strength, immediately after surgery. Accordingly, it would be highly desirable to provide an orthopaedic device and simplified procedure for rejoining severed connective tissue, or for strengthening damaged connective tissue, to facilitate anastomosis and recuperation thereof, while reducing trauma and discomfort to the patient, and while promot ⁇ ing rapid rehabilitation.
  • the invention provides an alternative method and device for repair and restoration of fully or partially separated or severed connective tissue such as ligaments, tendons, muscles and the like.
  • the device is an expansible sheath or sleeve which is either preasse - bled prior to surgery or assembled around the damaged connective tissue during surgery, and which serves to hold separated ends of connective tissue together and redistribute tensile loads around damaged tissue to facilitate healing and restoration thereof.
  • the connec ⁇ tive sheath or sleeve of the invention is formed from one or more flexible elongate members, such as fila ⁇ ments, wires, ribbons, strips or the like, which are formed into an open mesh.
  • the sleeve is generally comprised of a plurality of helically wound flexible elongate members of biocompatible material interwoven into an open mesh structure generally resem ⁇ bling a construct commonly known as a "Chinese finger trap" .
  • the connective sleeve of the invention when subjected to axial loading, i.e. tensile forces general ⁇ ly parallel to the axis of the sleeve, concurrently undergoes longitudinal expansion and radial contraction, whereupon connective tissue enveloped within the sleeve is firmly gripped and tensile forces are transmitted or redistributed to the sleeve.
  • the material from which the sleeve is fabricated can generally be any material having suitable mechanical properties, such as tensile strength and modulus, and which exhibits good biocompatibility. properties, such as non-antigenic and non-carcinogenic behavior.
  • the invention provides surgeons and particu- larly orthopaedic surgeons with an alternative procedure for healing separated connective tissue which reduces or eliminates the need for intrusive techniques involving the use of natural or synthetic prostheses and the usual steps associated with such procedures including the use of prostheses fixation devices such as surgical staples, screws .or anchors which are used to secure a prosthesis to a bone.
  • the invention also generally avoids steps involving drilling into bone and threading connective tissue or prosthesis therethrough.
  • the expansible orthopaedic sleeve and methods of the invention provide means by which separated connective tissue can be more easily rejoined for anastomosis thereof without signifi ⁇ cantly reducing the length of the connective tissue thereby eliminating the need for surgical techniques which involve tying or knotting the ends of severed connective tissue and thereby avoid stiffness problems which can be associated with such techniques.
  • the orthopaedic sleeve of the invention provides an effec ⁇ tive means for redistributing potentially injurious, tensile stresses around severed or damaged connective tissue by gripping the adjacent undamaged connective tissue more tightly and transferring a greater propor ⁇ tion of the tensile load through the sleeve and around the damaged or severed tissue as the tensile load is increased.
  • the invention thereby generally overcomes the problems usually associated with suturing techniques for rejoining severed or damaged connective tissue, and provides greater initial strength than suturing tech ⁇ niques.
  • the invention generally utilizes fewer components, requires fewer steps, and is less intrusive than prior surgical techniques, the patient experiences reduced trauma and discomfort, reduced exposure to antigenic reactions or infection, and quicker healing and restoration, of the damaged or severed connective tissue. Because the methods and device of the invention provide higher tensile strength, especially during the early post operative period as compared with convention ⁇ al surgical techniques and devices, it may be unneces ⁇ sary to immobilize joints associated with the damaged connective tissue, or to at least substantially lessen the type or time of immobilization required, thereby reducing atrophy and facilitating accelerated therapy, healing and restoration of the damaged tissue.
  • the invention allows for small relative movement (such as 1-2 millimeters) between the severed ends or damaged area of a connective tissue and permits limited axial loads to be transferred through the damaged connective tissue thereby promoting rapid restoration and rehabilitation of the damaged tissue, while trans ⁇ ferring larger, potentially injurious, axial loads around the damaged connective tissue and through the sleeve.
  • the invention therefore, permits early cyclic stressing of the damaged tissue. This cyclic stressing of the tissue during healing promotes regrowth and proper orientation of new tissue thereby facilitating a rapid recovery.
  • FIG. 1 is a perspective view of a connective sleeve in accordance with the principles of the inven ⁇ tion;
  • FIG. 2 illustrates the sleeve of FIG. 1 used to rejoin the severed ends of an anterior cruciate ligament;
  • FIG. 3 is a plan view of an open mesh struc ⁇ ture which is joinable at its sides to form an expansi- ble sleeve in accordance with the principles of the invention
  • FIG. 4 illustrates the use of the open mesh structure of FIG; 3 for bracing a damaged connective tissue to protect and facilitate healing thereof;
  • FIG. 5 shows an alternative embodiment of the invention provided with knurls or serrations to improve contact between the connective tissue and the sleeve;
  • FIG. 6 shows an alternative embodiment wherein the sleeve is composed of wire or filament elongate members
  • FIG. 7 is a transverse cross section of an expansible sleeve which is formed by joining the sides of an open mesh structure using an integral interlocking means comprising a rib and mating groove.
  • the expansible or expandable sleeve of the invention is generally indicated in FIG. 1 by reference numeral 10.
  • the sleeve 10 is an open mesh generally cylindrical construction which optionally can include a spiral cut opening in the wall which will permit the sleeve to be put onto a non-severed, injured tissue.
  • the sleeve 10 is constructed so that it will extend in the direction of its longitudinal axis and will con ⁇ strict radially substantially uniformly in response to a tensioned load in the longitudinal direction.
  • open mesh it is meant that the sleeve has open areas which enable the interwoven elongate members to scissor relative to each other.
  • the sleeve can be a cylindrically curved open mesh wall which is either tubular or spiral cut.
  • the sleeve is com ⁇ prised of a plurality of counter-helically wound flexi ⁇ ble elongate members 12 which are interwoven into an open mesh structure, or alternatively a uniform net-like construct in which the relative angle between connected elements changes in response to a load in the longitudinal direction.
  • the sleeves are generally con ⁇ structed from an even number of elongate members, such as 2, 4, 6 or 8, half of which are helically wound about an axis in one direction, the other half of which are wound about the axis in the opposite direction.
  • the elongate members 12 can each be folded over upon them ⁇ selves at an acute angle and then woven together such as into what is commonly known as a "basket-weave" , with the free ends being folded back or tucked in or other ⁇ wise suitably secured to prevent unravelling.
  • Other alternative constructs comprised of layers of opposing helically wound woven elongate members or netting which achieve the desired result of providing a sleeve 10 which, when subjected to tension generally along the longitudinal direction, undergoes concurrent longitudi ⁇ nal expansion and radial contraction to constrict and firmly grip an object enveloped therein are suitable for use with the invention.
  • the flexible longitudinal members 12 are preferably strips, ribbons, wires, filaments or the like. In order to maximize the distribution of forces over the interface between the sleeve 10 and the tissue enveloped therein, the elongate members 12 preferably have a flat cross-section such as ribbons or strips.
  • the wires When wires or filaments are used, it is preferred that the wires have a non-circular cross-section, such as a flattened elliptical shape wherein the flattened surfac ⁇ es face the longitudinal axis of the sleeve so as to increase the area of contact between the elongate members 12 and the tissue enveloped by the sleeve 10 to distribute forces over a greater area of tissue and to prevent the elongate members from cutting into the connective tissue.
  • a non-circular cross-section such as a flattened elliptical shape wherein the flattened surfac ⁇ es face the longitudinal axis of the sleeve so as to increase the area of contact between the elongate members 12 and the tissue enveloped by the sleeve 10 to distribute forces over a greater area of tissue and to prevent the elongate members from cutting into the connective tissue.
  • the elongate members 12 are woven into an open mesh cylindrical structure having openings in the side walls 14 to allow the overlapping or crossed elongate members 12 to move relative to one another to permit concurrent longitudinal expansion and radial contraction of the sleeve 10 when tensile loads are applied approxi ⁇ mately longitudinally to the sleeve.
  • These openings 14 permit extrinsic fluid transport to allow the injury site access to healing nutrients which help repair cells.
  • the woven sheath compresses and extends creating small relative movements between the strips of material from which it is woven. This motion encourages ingrowth of collagenous fibers along the surface of the sheath itself so as to encapsulate and anchor the sheath to the injured tissue, thus reinforcing the injury site and reducing the chance of a repeat injury.
  • the elongate members 12 are generally formed from a biocompatible material having suitable mechanical properties such as flexibility, tensile strength and modulus.
  • suitable flexibility generally refers to a combination of dimensional and physical properties which allow the elongate members 12 to be helically wound without breaking.
  • the elongate members 12 should preferably have a tensile strength which is at least about equal to or which is slightly greater than the tensile strength of healthy connective tissue of the type which is to be restored.
  • the elongate members generally have a relatively high modulus which is at least equal to that of healthy connective of the type which is to be restored.
  • Biocompatibility refers to the absence of any undesired reactions with surrounding tissues, such as antigenic or carcinogenic reactions.
  • Suitable biocompatible materials for use with the invention include for example surgical quality stainless steel or other biocompatible alloys; polytetrafluoroethylene
  • PTFE polyethyleneterephthalate
  • PET polyethyleneterephthalate
  • polypropylene polyethylene
  • polyesters polyamides or other biocompatible synthetic polymers
  • suitable biocompatible materials such as carbon fibers, reconstituted collagen strips or fibers and the like.
  • Preferred materials for constructing the sleeve 10 include surgical grade stainless steel and any of various biocompatible synthetic polymers. Ribbons or strips, when used as the elongate members 12, can be either a continuous material such as stainless steel or polymeric ribbon, or can be a fabric formed from a plurality of fibers or filaments woven, knitted or otherwise made into a fabric having suitable properties.
  • biocompatible polymers When used to form the elon- gate members 12, they can either be permanent, non- biodegradable polymers, or slowly biodegrading polymers which can be resorbed into the growing tissue.
  • One attractive option envisioned involves forming collage- nous fibers into suitable strips, ribbons or filaments which are used as elongate members 12 which form the sleeve 10.
  • Sleeve 10 is used to rejoin severed, torn, ruptured or otherwise separated connective tissues, such as an anterior cruciate ligament 16 as shown in FIG. 2.
  • a sleeve 10 having suitable dimensions for rejoining the severed connective tissues is first prepared or select ⁇ ed.
  • the sleeve 10 should, when subjected to longitudi ⁇ nal compression, have a radius which is large enough to allow the sleeve to be easily slipped over the severed ends of connective tissue 16 during surgery.
  • the sleeve should fit snugly on the connective tissue when it is decompressed onto the tissue.
  • the sleeve should, when subjected to longitudinal tension, also achieve a radial contraction which causes the sleeve to constrict and firmly grip relatively healthy, undamaged tissue adjacent to the damaged tissue, such that the tensile stresses are directed around the damaged tissue and through the sleeve 10.
  • the sleeve should also be of a suitable length to allow sufficient gripping of the relatively healthy, undamaged tissue to permit the tensile stresses to be transferred to the sleeve 10.
  • Typical dimension for an unstressed sleeve for use in the repair of human connective tissue generally include a radius in the range from about 0.1 or 0.2 mm to about 3, 4 or 5 mm and a length of from about 1 or 2 cm up to about 4 or 5 cm, depending upon the particular application.
  • the inven ⁇ tion can also be used to aid in the restoration of severed or damaged animal connective tissue, in which case the dimensions of the sleeve will be appropriately selected for the particular application.
  • the thickness of the ribbons, strips, wires, filaments or the like used to form the sleeves, as measured along a radius of the sleeve, is generally from about 0.005 mm up to about 1 or 2 mm, depending on various factors such as the amount of strength needed for the particular application and the type of biocompatible material being used to form the sleeve.
  • the radius Upon axially compressing the sleeve, the radius generally can be increased to a maximum of from about 10 to about 100 percent of its unstressed radius and the length can be decreased by as much as about 10 to about 50 percent of the unstressed length.
  • the radius of the sleeve can be reduced to a minimum of from about 10 to about 50 percent of its unstressed radius and the length can be increased to as much as from about 10 to about 50 percent of the unstressed length.
  • the sheath should be expandable to a diameter of about 50 percent larger than the width of the tendon to be repaired and should be contractible to no less than about 75 percent of the width of the tendon to be repaired.
  • Rejoining of severed, torn or otherwise separated connective tissue 16 using the sleeve 10 of the invention is achieved by first exposing and locating the severed ends in accordance with conventional tech ⁇ niques.
  • the sleeve 10 is longitudinally compressed and held in the compressed state by means of, for example, a temporary suture.
  • a first of the severed ends of the connective tissue 16 is threaded through the sleeve 10.
  • the severed ends of the connective tissue 16 can be sutured together using conventional techniques if the surgeon deems it appro ⁇ priate.
  • the sutures are most desirably of the biodegradable variety which break down over a period of time and are resorbed into the tissue.
  • One end of the sleeve 10 is then suitably secured to a relatively healthy, undamaged area of the connective tissue 16 adjacent to one of the severed ends such as by suturing or by using a suitable surgical adhesive. If the severed ends have been sutured together, then it is necessary to remove the temporary suture or other means for compressing the sleeve 10, and desirably pull the sleeve over the second severed end of the connective tissue 16 with sufficient force such that the tissue at the severed ends are slightly under compression, i.e.
  • the other end of the sleeve is then preferably suitably secured, such as by suturing or by means of a suitable surgical adhesive, to the second severed end of the connective tissue, thereby providing a brace which will allow the damaged tissue to experience a limited amount of tensile load and a limited amount of movement to promote healing and proper orientation of regrowth tissue, while redirecting larger tensile stresses around the damaged tissue and through the sleeve 10.
  • the ends of the sleeve 10 will normally be secured to the respective ends of the severed connective tissue 16 such as by means of sutures or a suitable surgical adhesive composition
  • the sleeve can be used without securing either or both ends thereof to respec- tive ends of the severed connective tissue. That is to say, it is possible to rely strictly on friction and/or other interactions between the internal surface of the sleeve 10 and the outer surface of the connective tissue.
  • miniature hooks or barbs 18 can be provided on the internal surface of the sleeve.
  • Other means for improving contact between the connective tissue and the sleeve include providing the internal surface with knurls, serrations 19 or the like as shown in FIG. 5.
  • FIGS. 3-5 an open mesh preform structure 20 which can be formed into an expandable sleeve 22 is shown in FIGS. 3-5.
  • the open mesh structure 20 is comprised of a plurality of inter ⁇ woven flexible elongate members 24 of biocompatible material.
  • the structure has opposing sides 26 and 28 which are joinable to form an expandable sleeve 22 generally comparable in function to the sleeve 10 of the first embodiment. The primary difference being that the sleeve is fully or partially joined together during the surgery.
  • the open mesh structure 20 is used to aid in the healing of partially torn or otherwise damaged connective tissue 42, which has not been completely severed, by wrapping the open mesh structure around the damaged tissue and connecting individual ends 30a, 30b, 30c, etc. of elongate members 24 on one side 26 of the structure 20 with corresponding or matching ends 34a, 34b, 34c, etc. of another member on the other side 28 to form the sleeve 22 as shown in FIG. 4.
  • the ends 30a, 30b, 30c, etc. and 34a, 34b, 34c, etc. can be connected to one another such as by sutures 36, by interlocking means, such as a rib 38 and groove 40 (as shown in FIG. 7), or a combination thereof.
  • the ends of the sleeve are pulled apart, preferably while the damaged tissue area is subjected to a small amount of compres ⁇ sion, such that the sleeve tightly grips relatively healthy, undamaged areas of the connective tissue 42 adjacent to the damaged area, whereby the damaged tissue may be subjected to relatively small longitudinal tensile stresses which prevent atrophy, facilitate proper orientation of regrowth tissue, and generally promote restoration, while redistributing relatively large longitudinal tensile stresses around the damaged tissue and through the sleeve 22.
  • An alternative embodiment of the expansible sleeve 50 of the invention is shown in FIG. 6 wherein the elongate members are wires or filaments 52.
  • the method of the invention can of course be applied to more elaborate and detailed fabrication procedures wherein the sleeve is partially preassembled or fully assembled in situ, the above embodiments merely representing what the inventors currently regard as the most practical modes for practicing the invention.
  • the devices and methods of the invention provide a simplified procedure for rejoining severed connective tissue and for bracing damaged connective tissue which is not completely severed.
  • the sleeve of the invention can either be a permanent, non-biodegradable type which becomes envel- oped by the new tissue and which provide permanent strength to the connective tissue, or it can be of the bioabsorbable type which is resorbed into the tissue or broken down and removed from the body over a period of time sufficient to allow complete restoration of the severed or damaged connective tissue.
  • the invention can be used in association with conventional prostheses in certain situations.
  • the orthopaedic sleeve of the invention can be used for joining severed connective tissue to one end of a prosthesis with the other end of the prosthesis being anchored to a bone in a conventional manner, or two orthopaedic sleeves can be used for connecting separated ends of a connective tissue through an intervening prosthesis.

Landscapes

  • Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Epidemiology (AREA)
  • Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Rehabilitation Therapy (AREA)
  • Rheumatology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Inorganic Chemistry (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un manchon extensible (10, 22, 50) permettant de rejoindre et/ou de consolider un tissu connectif lésé (16, 42) tel que celui de ligaments, de tendons, de muscles et autres. Ce manchon est constitué d'une pluralité d'éléments oblongs (12, 24, 52) en substance biocompatible tissés en une structure réseau ouverte (20) qui peut subir concurremment une expansion axiale et une contraction radiale lorsqu'il est soumis à des efforts axiaux. Le manchon extensible permet de petits mouvements et le transfert de petits efforts axiaux au moyen du tissu connectif lésé, ce qui favorise la reconstitution et la réhabilitation rapides du tissu lésé, tout en transférant les efforts axiaux plus importants et potentiellement lésants autour du tissu connectif lésé et au travers du manchon. L'invention propose un dispositif et un procédé facilitant la reconstitution de tissu connectif lésé, tout en étant moins invasive et traumatisante que les procédés conventionnels.
PCT/US1995/009417 1994-07-26 1995-07-25 Dispositif et procede de reconstitution de tissu connectif WO1996003084A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU31477/95A AU3147795A (en) 1994-07-26 1995-07-25 Device and method for restoration of connective tissue

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US28036394A 1994-07-26 1994-07-26
US08/280,363 1994-07-26

Publications (1)

Publication Number Publication Date
WO1996003084A1 true WO1996003084A1 (fr) 1996-02-08

Family

ID=23072763

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1995/009417 WO1996003084A1 (fr) 1994-07-26 1995-07-25 Dispositif et procede de reconstitution de tissu connectif

Country Status (2)

Country Link
AU (1) AU3147795A (fr)
WO (1) WO1996003084A1 (fr)

Cited By (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2745710A1 (fr) * 1996-03-11 1997-09-12 Rippstein Pascal Francois Dispositif passe-tendon
WO1998037835A1 (fr) * 1997-02-25 1998-09-03 Philip Stuart Esnouf Aide chirurgicale pour la greffe de tissu conjonctif et son procede d'utilisation
GB2324471A (en) * 1997-04-25 1998-10-28 Univ London Tendon grafting aid
AU731936B2 (en) * 1997-02-25 2001-04-05 Philip Stuart Esnouf Surgical aid for connective tissue grafting and method for employing same
WO2001056506A1 (fr) 2000-02-02 2001-08-09 Ricana Ag Implant destine a la fixation temporaire de tissus
WO2006117398A3 (fr) * 2005-05-04 2007-06-21 Etech Ag Element de liaison
US8167952B2 (en) 2008-09-03 2012-05-01 The Cleveland Clinic Foundation Arthroplastic implant with shield for basilar joint and related methods
US8231625B2 (en) 2008-09-03 2012-07-31 The Cleveland Clinic Foundation Modular bone fixation device for treatment of fractures and related methods
US8343228B2 (en) 2008-09-03 2013-01-01 The Cleveland Clinic Foundation Arthroplastic implant with anchor peg for basilar joint and related methods
US8506641B2 (en) 2008-09-03 2013-08-13 The Cleveland Clinic Foundation Arthrodesis implant for finger joints and related methods
US8956394B1 (en) 2014-08-05 2015-02-17 Woven Orthopedic Technologies, Llc Woven retention devices, systems and methods
CN104936536A (zh) * 2013-01-06 2015-09-23 医药连接技术-医连技术-M·C·T·有限公司 连接器
USD740427S1 (en) 2014-10-17 2015-10-06 Woven Orthopedic Technologies, Llc Orthopedic woven retention device
US9585695B2 (en) 2013-03-15 2017-03-07 Woven Orthopedic Technologies, Llc Surgical screw hole liner devices and related methods
US9907593B2 (en) 2014-08-05 2018-03-06 Woven Orthopedic Technologies, Llc Woven retention devices, systems and methods
US9943351B2 (en) 2014-09-16 2018-04-17 Woven Orthopedic Technologies, Llc Woven retention devices, systems, packaging, and related methods
US10555758B2 (en) 2015-08-05 2020-02-11 Woven Orthopedic Technologies, Llc Tapping devices, systems and methods for use in bone tissue
US10660638B2 (en) 2012-03-01 2020-05-26 DePuy Synthes Products, Inc. Surgical suture with soft core
US11395681B2 (en) 2016-12-09 2022-07-26 Woven Orthopedic Technologies, Llc Retention devices, lattices and related systems and methods

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3626947A (en) * 1970-02-19 1971-12-14 Charles Howard Sparks Method and apparatus for vein and artery reenforcement
US4301551A (en) * 1979-05-24 1981-11-24 Ecole Polythechnique Deformable high energy storage tension spring
US4585458A (en) * 1981-06-10 1986-04-29 Kurland Kenneth Z Means and method of implanting bioprosthetics
US5234448A (en) * 1992-02-28 1993-08-10 Shadyside Hospital Method and apparatus for connecting and closing severed blood vessels

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3626947A (en) * 1970-02-19 1971-12-14 Charles Howard Sparks Method and apparatus for vein and artery reenforcement
US4301551A (en) * 1979-05-24 1981-11-24 Ecole Polythechnique Deformable high energy storage tension spring
US4585458A (en) * 1981-06-10 1986-04-29 Kurland Kenneth Z Means and method of implanting bioprosthetics
US5234448A (en) * 1992-02-28 1993-08-10 Shadyside Hospital Method and apparatus for connecting and closing severed blood vessels

Cited By (40)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2745710A1 (fr) * 1996-03-11 1997-09-12 Rippstein Pascal Francois Dispositif passe-tendon
WO1997033535A1 (fr) * 1996-03-11 1997-09-18 Rippstein Pascal Francois Dispositif passe-tendon
US6143029A (en) * 1996-03-11 2000-11-07 Rippstein; Pascal Francois Tendon guide device
WO1998037835A1 (fr) * 1997-02-25 1998-09-03 Philip Stuart Esnouf Aide chirurgicale pour la greffe de tissu conjonctif et son procede d'utilisation
AU731936B2 (en) * 1997-02-25 2001-04-05 Philip Stuart Esnouf Surgical aid for connective tissue grafting and method for employing same
EP1011535A4 (fr) * 1997-02-25 2002-01-16 Philip Stuart Esnouf Aide chirurgicale pour la greffe de tissu conjonctif et son procede d'utilisation
US6602290B2 (en) 1997-02-25 2003-08-05 Centerpulse Orthopedics Inc. Surgical aid for connective tissue grafting and method for employing same
GB2324471A (en) * 1997-04-25 1998-10-28 Univ London Tendon grafting aid
WO1998048736A1 (fr) * 1997-04-25 1998-11-05 University College London Auxiliaire de greffe du tendon
WO2001056506A1 (fr) 2000-02-02 2001-08-09 Ricana Ag Implant destine a la fixation temporaire de tissus
US12268384B2 (en) 2005-05-04 2025-04-08 DePuy Synthes Products, Inc. Joining element
WO2006117398A3 (fr) * 2005-05-04 2007-06-21 Etech Ag Element de liaison
US9757120B2 (en) 2005-05-04 2017-09-12 DePuy Synthes Products, Inc. Joining element
US10542972B2 (en) 2005-05-04 2020-01-28 DePuy Synthes Products, Inc. Joining element
AU2006243216B2 (en) * 2005-05-04 2011-09-22 Synthes Gmbh Joining element
US11471154B2 (en) 2005-05-04 2022-10-18 DePuy Synthes Products, Inc. Joining element
KR101387070B1 (ko) 2005-05-04 2014-04-18 진테스 게엠베하 결합 부재
US8870915B2 (en) 2005-05-04 2014-10-28 DePuy Synthes Products, LLC Joining element
US9757121B2 (en) 2005-05-04 2017-09-12 DePuy Synthes Products, Inc. Joining element
US8506641B2 (en) 2008-09-03 2013-08-13 The Cleveland Clinic Foundation Arthrodesis implant for finger joints and related methods
US8343228B2 (en) 2008-09-03 2013-01-01 The Cleveland Clinic Foundation Arthroplastic implant with anchor peg for basilar joint and related methods
US8231625B2 (en) 2008-09-03 2012-07-31 The Cleveland Clinic Foundation Modular bone fixation device for treatment of fractures and related methods
US8167952B2 (en) 2008-09-03 2012-05-01 The Cleveland Clinic Foundation Arthroplastic implant with shield for basilar joint and related methods
US10660638B2 (en) 2012-03-01 2020-05-26 DePuy Synthes Products, Inc. Surgical suture with soft core
CN104936536A (zh) * 2013-01-06 2015-09-23 医药连接技术-医连技术-M·C·T·有限公司 连接器
US10064625B2 (en) 2013-01-06 2018-09-04 Medical Connection Technology—Mediconntech—M.C.T. Ltd Connector
JP2016506280A (ja) * 2013-01-06 2016-03-03 メディカル コネクション テクノロジー − メディコンテック−エム．シー．ティー．エルティーディー 連結具
EP2941198A4 (fr) * 2013-01-06 2016-03-30 Medical Connection Technology Mediconntech M C T Ltd Connecteur
US9585695B2 (en) 2013-03-15 2017-03-07 Woven Orthopedic Technologies, Llc Surgical screw hole liner devices and related methods
US9808291B2 (en) 2014-08-05 2017-11-07 Woven Orthopedic Technologies, Llc Woven retention devices, systems and methods
US9907593B2 (en) 2014-08-05 2018-03-06 Woven Orthopedic Technologies, Llc Woven retention devices, systems and methods
US9532806B2 (en) 2014-08-05 2017-01-03 Woven Orthopedic Technologies, Llc Woven retention devices, systems and methods
US10588677B2 (en) 2014-08-05 2020-03-17 Woven Orthopedic Technologies, Llc Woven retention devices, systems and methods
US11376051B2 (en) 2014-08-05 2022-07-05 Woven Orthopedic Technologies, Llc Woven retention devices, systems and methods
US8992537B1 (en) 2014-08-05 2015-03-31 Woven Orthopedic Technologies, Llc Woven retention devices, systems and methods
US8956394B1 (en) 2014-08-05 2015-02-17 Woven Orthopedic Technologies, Llc Woven retention devices, systems and methods
US9943351B2 (en) 2014-09-16 2018-04-17 Woven Orthopedic Technologies, Llc Woven retention devices, systems, packaging, and related methods
USD740427S1 (en) 2014-10-17 2015-10-06 Woven Orthopedic Technologies, Llc Orthopedic woven retention device
US10555758B2 (en) 2015-08-05 2020-02-11 Woven Orthopedic Technologies, Llc Tapping devices, systems and methods for use in bone tissue
US11395681B2 (en) 2016-12-09 2022-07-26 Woven Orthopedic Technologies, Llc Retention devices, lattices and related systems and methods

Also Published As

Publication number Publication date
AU3147795A (en) 1996-02-22

Similar Documents

Publication Publication Date Title
WO1996003084A1 (fr) Dispositif et procede de reconstitution de tissu connectif
US4469101A (en) Suture device
US9888996B2 (en) In vivo hydraulic fixation including bio-rivets using biocompatible expandable fibers
JP2740531B2 (ja) プレストレス（ｐｒｅｓｔｒｅｓｓ）を加えた外科用網状物
ES2252825T3 (es) Ayuda quirurgica para implantacion de tejido conectivo.
KR101095771B1 (ko) 천연 조직 장치와 이식 방법
US11918454B2 (en) Tissue fixation device
US20070135920A1 (en) Sutures for use in the repair of defects in the anulus fibrosus
AU2004226920A1 (en) Apparatus and methods for tendon or ligament repair
US20100211174A1 (en) Method For Repairing A Rotator Cuff
JP2023513058A (ja) 無結紮式軟組織インプラントシステム及び関連方法
AU2017202825A1 (en) Device, system, and method for delivery of a tissue fixation device
CN112494174A (zh) 一种界面锚钉编织钉鞘装置及其制作方法
US20230055112A1 (en) Collagen Construct and Method for Producing the Collagen Construct
HK1236140B (zh) 胶原构建物及用於产生所述胶原构建物的方法
NZ730479B2 (en) Collagen construct and method for producing the collagen construct

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AM AT AU BB BG BR BY CA CH CN CZ DE DK EE ES FI GB GE HU IS JP KE KG KP KR KZ LK LR LT LU LV MD MG MN MW MX NO NZ PL PT RO RU SD SE SG SI SK TJ TM TT UA UG UZ VN

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): KE MW SD SZ UG AT BE CH DE DK ES FR GB GR IE IT LU MC NL PT SE BF BJ CF CG CI CM GA GN ML MR NE SN TD TG

DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
121 Ep: the epo has been informed by wipo that ep was designated in this application
REG Reference to national code

Ref country code: DE

Ref legal event code: 8642

122 Ep: pct application non-entry in european phase
DPE2 Request for preliminary examination filed before expiration of 19th month from priority date (pct application filed from 20040101)