DE4112205A1 - Method of transplanting crucial ligaments of knee joint - involves first stretching ligaments to prevent subsequent relaxation - Google Patents

Method of transplanting crucial ligaments of knee joint - involves first stretching ligaments to prevent subsequent relaxation

Info

Publication number
DE4112205A1
DE4112205A1 DE4112205A DE4112205A DE4112205A1 DE 4112205 A1 DE4112205 A1 DE 4112205A1 DE 4112205 A DE4112205 A DE 4112205A DE 4112205 A DE4112205 A DE 4112205A DE 4112205 A1 DE4112205 A1 DE 4112205A1
Authority
DE
Germany
Prior art keywords
ligaments
knee joint
crucial
ligament
scale
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.)
Withdrawn
Application number
DE4112205A
Other languages
German (de)
Inventor
Andreas Altrichter
Bernd Bocher
Hans-Joachim Dr Rer Nat Hein
Volker Reichenbach
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Martin Luther Universitaet Halle Wittenberg
Original Assignee
Martin Luther Universitaet Halle Wittenberg
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 Martin Luther Universitaet Halle Wittenberg filed Critical Martin Luther Universitaet Halle Wittenberg
Priority to DE4112205A priority Critical patent/DE4112205A1/en
Publication of DE4112205A1 publication Critical patent/DE4112205A1/en
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/08—Muscles; Tendons; Ligaments
    • A61F2/0805—Implements for inserting tendons or ligaments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • A61B2017/0268—Joint distractors for the knee

Abstract

When the crucial ligaments of a knee joint are transplanted, each ligament is subject to a force which stretches it beyond its elastic limit in order to ensure that the ligament does not relax after being transplanted. The ligaments are stretched by means of a device with a spring-loaded slider which is adjusted before use by rotating the knurled knob (2) so that the scale (4) reads zero. One end of the ligament is attached to the hook (1) and the other end attached to the bone of the knee joint. The knee joint is actuated and the load imposed on the ligament is indicated on the scale (4) and the change in length on the scale (3). USE/ADVANTAGE - Transplant of the crucial ligaments of a knee joint. The method prevents relaxation of the ligaments after transplantation.

Description

Anwendungsgebiet der ErfindungField of application of the invention

Die Erfindung betrifft eine Vorrichtung (Arthro-Isometer), die es gestattet, am offenen Kniegelenk die Fixationspunkte für den Ersatz des vorderen Kreuzbandes zu finden und zu markieren. Das Arthro-Isome­ ter wird zur intraoperativen Messung des isometrischen Punktes für das vordere und hintere Kreuzbandersatzmaterial verwendet, um die erfor­ derlichen Bohrkanäle und Spannungsverhältnisse anatomiegerecht zu bestimmen. Die Vorrichtung wird auch in der arthroskopischen Chirurgie Anwendung finden, so daß sie sowohl intraarticulär als auch extraarticulär einsetzbar ist.The invention relates to a device (Arthro-Isometer), it allowed, the fixation points for the replacement on the open knee joint to find and mark the anterior cruciate ligament. The arthro isome ter is used for the intraoperative measurement of the isometric point for the anterior and posterior cruciate ligament replacement material used to provide the requisite to the anatomical requirements of the drilling channels and tension conditions determine. The device is also used in arthroscopic surgery Find application so that they are both intra-articular and can be used extraarticularly.

Charakteristik der bekannten LösungenCharacteristic of the known solutions

Die bisherige Verfahrensweise beruhte auf der Erfahrung des Opera­ teurs. Mit einem Meßfaden wurden die an den zu fixierenden Stellen eingebrachten Schrauben verbunden und durch Beugen und Strecken des Knies die Längenänderung ermittelt. Zur Kraftmessung wurden in der Regel Federwaagen verwendet.The previous procedure was based on the experience of the Opera expensive. With a measuring thread, those at the points to be fixed inserted screws connected and by bending and stretching the Knee determined the change in length. For force measurement in the Usually spring scales are used.

Die bisher bekannt gewordenen Verfahren und Vorrichtungen konnten nur bei der Arthrotomie des Knies erfolgreich eingesetzt werden. Sie sind in der Regel sehr aufwendig konstruiert und zu kompliziert, um unter der Operation von einem wenig geübten Operateur erfolgreich angewendet zu werden. Die Fixpunkte werden ungenau, so daß es beim Patienten zu Behinderungen kommen kann. Die von der Firma Smith and Nephrew (Dyonics) angebotene Vorrichtung ist für den vorliegenden Zweck zwar geeignet, bedeutet aber einen erheblichen materiellen Aufwand, eine Kraftmessung ist damit nicht vorgesehen.The previously known methods and devices could only successfully used in the arthrotomy of the knee. you are usually very elaborate and too complicated to take the operation was successfully applied by a less experienced surgeon to become. The fixed points become inaccurate, so that the patient too Disabilities can come. The company Smith and Nephrew Device offered by (Dyonics) is for the present purpose though suitable, but means a considerable material effort, a Force measurement is therefore not provided.

In der einschlägigen Fachliteratur wurde in der Zeitschrift "Arthroskopie" (1989), 2, S. 63-66 ein Artikel gefunden, der eine ähnliche Vorrichtung kritisch beschreibt.In the relevant specialist literature was in the magazine "Arthroscopy" (1989), 2, pp. 63-66 found an article containing a critically describes similar device.

Ziel der ErfindungAim of the invention

Ziel der Erfindung ist es, eine Verbesserung der Isometrie des Muskel und Bandapparates am offenen oder arthroskopierten Kniegelenk zu erreichen, um durch fehlerhafte Implantation verursachte postoperative Instabilität auszuschließen. The aim of the invention is to improve the isometry of the muscle and ligaments on the open or arthroscopic knee joint reach to postoperative caused by faulty implantation Exclude instability.  

Darlegung des Wesens der ErfindungState the nature of the invention

Es war eine Vorrichtung zu entwickeln, die es ermöglicht, unter der Operation am offenen Knie einfach und genau die Fixationspunkte und damit die Länge des Bandersatzes festzulegen. Mit der Anwendung der Vorrichtung wird eine verstärkte Elongation des Transplantates über die Grenze der elastischen Verformbarkeit hinaus und damit eine über­ mäßige Erschlaffung vermieden. Die Vorrichtung erlaubt es, eine kon­ stante Länge und konstante Spannung des Transplantates im Rahmen der Kreuzbandersatzchirurgie bei passiver Funktionskontrolle einzustellen. Vor Beginn der Messung wird die Rändelmutter 2 (siehe Abbildung) so gedreht, daß die Skala auf der rechten Seite auf "0" kp eingestellt wird. Anschließend wird die Spannvorrichtung an "1" in eine Schraube mit Längsloch eingehängt. Die Schraube ist im Knochen unterhalb des Knies befestigt. Dann wird in die Öse am oberen Ende der Faden straff angebunden, aber so, daß die Skala "4" noch "0" kp anzeigt. An der Rändelmutter wird jetzt die Spannung (z. B. 1, 2, 3 oder 4 kp) einge­ stellt, je nach der geforderten Vorspannung des Transplantatmaterials. Auf der gegenüberliegenden Skala "3" kann die Längenabweichung bei Flexions- und Extensionsstellung des Kniegelenkes in Millimeter abgelesen werden (Die Vorspannung bleibt während dieser Phase unver­ änderlich).A device had to be developed that made it possible to easily and precisely determine the fixation points and thus the length of the ligament replacement during the operation on the open knee. With the use of the device, an increased elongation of the graft beyond the elastic deformability limit and thus an excessive relaxation is avoided. The device allows a constant length and constant tension of the graft to be set in the context of cruciate ligament replacement surgery with passive function control. Before starting the measurement, the knurled nut 2 (see illustration) is turned so that the scale on the right side is set to "0" kp. Then the tensioning device is attached to " 1 " in a screw with a longitudinal hole. The screw is attached in the bone below the knee. Then the thread is tied tightly in the eyelet at the upper end, but so that the scale " 4 " still indicates "0" kp. The tension (e.g. 1, 2, 3 or 4 kp) is now set on the knurled nut, depending on the required pretension of the graft material. On the opposite scale " 3 ", the length deviation in flexion and extension position of the knee joint can be read in millimeters (the preload remains unchanged during this phase).

Die Fixierung hat so zu erfolgen, daß beim Beugen und Strecken des Kniegelenkes nur eine geringfügige Verschiebung des Meßfadens statt­ findet (max. ±2,5 mm).The fixation must be such that when bending and stretching the Knee joint only a slight shift of the measuring thread instead finds (max. ± 2.5 mm).

Claims (1)

Vorrichtung zur isometrischen Plazierung des plastischen vorderen Kreuzbandersatzes, gekennzeichnet dadurch, daß Lage, Länge und Belastung des Transplantates durch eine an den Fixationspunkt befestigte Spannvorrichtung über die Veränderung des Meßfadens in Abhängigkeit von der geforderten Vorspannung des Transplantates bestimmt wird, indem durch eine Rändelmutter die Spannungs- und die Längenskala jeweils auf "0" eingestellt wird, wobei der am oberen Ende der Spannvorrichtung und am Fixationspunkt befestigte Faden gestrafft und die Spannung des Transplantates bei gleichzeitiger Registrierung der Längenabweichung während der Bewegung des Knies eingestellt wird.Device for isometric placement of the plastic anterior cruciate ligament replacement, characterized in that the position, length and loading of the graft is determined by a tensioning device attached to the fixation point via the change in the measuring thread depending on the required pretensioning of the graft, by means of a knurled nut to determine the tension and the length scale is set to "0" in each case, the thread attached to the upper end of the tensioning device and to the fixation point being tightened and the tension of the graft being adjusted while simultaneously registering the length deviation during the movement of the knee.
DE4112205A 1991-04-13 1991-04-13 Method of transplanting crucial ligaments of knee joint - involves first stretching ligaments to prevent subsequent relaxation Withdrawn DE4112205A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
DE4112205A DE4112205A1 (en) 1991-04-13 1991-04-13 Method of transplanting crucial ligaments of knee joint - involves first stretching ligaments to prevent subsequent relaxation

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DE4112205A DE4112205A1 (en) 1991-04-13 1991-04-13 Method of transplanting crucial ligaments of knee joint - involves first stretching ligaments to prevent subsequent relaxation

Publications (1)

Publication Number Publication Date
DE4112205A1 true DE4112205A1 (en) 1992-10-15

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Family Applications (1)

Application Number Title Priority Date Filing Date
DE4112205A Withdrawn DE4112205A1 (en) 1991-04-13 1991-04-13 Method of transplanting crucial ligaments of knee joint - involves first stretching ligaments to prevent subsequent relaxation

Country Status (1)

Country Link
DE (1) DE4112205A1 (en)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2370232A (en) * 2000-09-28 2002-06-26 Wolf Gmbh Richard A device for conditioning a ligament to be implanted
EP1297798A3 (en) * 2001-09-28 2003-12-10 Ethicon, Inc. Variable graft tensioner

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4712542A (en) * 1986-06-30 1987-12-15 Medmetric Corporation System for establishing ligament graft orientation and isometry
US4739751A (en) * 1986-10-03 1988-04-26 Temple University Apparatus and method for reconstructive surgery

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4712542A (en) * 1986-06-30 1987-12-15 Medmetric Corporation System for establishing ligament graft orientation and isometry
US4739751A (en) * 1986-10-03 1988-04-26 Temple University Apparatus and method for reconstructive surgery

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2370232A (en) * 2000-09-28 2002-06-26 Wolf Gmbh Richard A device for conditioning a ligament to be implanted
GB2370232B (en) * 2000-09-28 2004-03-31 Wolf Gmbh Richard A device for conditioning a ligament to be implanted
US6723125B2 (en) 2000-09-28 2004-04-20 Richard Wolf Gmbh Device for conditioning a ligament to be implanted
EP1297798A3 (en) * 2001-09-28 2003-12-10 Ethicon, Inc. Variable graft tensioner
US6796977B2 (en) 2001-09-28 2004-09-28 Depuy Mitek, Inc. Variable graft tensioner

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Legal Events

Date Code Title Description
ON Later submitted papers
OP8 Request for examination as to paragraph 44 patent law
8125 Change of the main classification

Ipc: A61F 2/76

8139 Disposal/non-payment of the annual fee