CN105101885A - 小型化的双驱动器开放构造缝线锚件 - Google Patents

小型化的双驱动器开放构造缝线锚件 Download PDF

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CN105101885A
CN105101885A CN201480014353.5A CN201480014353A CN105101885A CN 105101885 A CN105101885 A CN 105101885A CN 201480014353 A CN201480014353 A CN 201480014353A CN 105101885 A CN105101885 A CN 105101885A
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M.E.豪斯曼
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Smith and Nephew Inc
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Smith and Nephew Richards Inc
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Abstract

本公开提供一种用于将软组织紧固到骨骼的开放构造锚件（100）的示例，例如用于修复撕裂的回旋肌腱。所述锚件包括：至少一个开放螺旋绕圈（105），其限定多边形内容积（110）；和至少一个肋（120），其设置在所述多边形内容积内并连接到所述至少一个开放螺旋绕圈的至少两个匝。所述至少一个肋定尺寸成接合驱动器（300），所述至少一个肋和所述多边形内容积的组合定尺寸成提供驱动所述锚件进入骨骼中所需的锚件驱动扭矩。

Description

小型化的双驱动器开放构造缝线锚件
背景技术
关节镜手术是微创手术过程，其中关节内部损伤的检查以及有时的处理使用关节镜进行，关节镜是一种类型的内窥镜，其通过小切口插入到关节中。关节镜手术过程，例如修复撕裂的回旋肌腱，常常需要将软组织重新附接到骨骼。为实现这一目的，锚件（有时称为“缝线锚件”）安置在骨骼中，附接到锚件的缝线穿过该组织以将该组织牢固保持就位。
发明内容
为了减小由于锚件去除的骨存量并使侵入性最小，正在使用更小的开放构造锚件。不过，更小的开放构造锚件导致：在减小锚件内容积与削弱驱动器支撑结构之间的折衷是有问题的。为了在拧入式插入过程中保持结构完整性，驱动器元件必须能够承受插入锚件所需的扭力。驱动器肋典型地设置在锚件的内容积内，以提供结构元件而用于使驱动器在插入过程中施加扭力。不过，随着锚件尺寸减小，用于驱动锚件的适合深度/尺寸的驱动器肋开始阻碍内部缝线通过。因而需要一种驱动器支撑结构，其能够在锚件插入过程中承受扭转驱动力，并具有足够小的构形以避免阻碍内部缝线通过。
上述需要通过一种具有双驱动器系统的开放构造锚件得以实现，其使用驱动器肋和内部多边形（例如，六边形、八边形、正方形、或任何其它的规则或不规则的多边形）的驱动器特征。这种新式双驱动器特征允许锚件承受扭转驱动力，而同时包括尺寸减小的驱动器肋。锚件的内容积由此得以维持从而提供恰当的横截面积，用于使缝线穿过锚件和/或驱动器。使用更小的锚件允许骨存量的保持和更快的恢复健康。
相应地，在一个方面，在此所述的至少一个实施例涉及一种锚件，用于将软组织紧固到骨骼，例如用以修复撕裂的回旋肌腱。锚件包括：至少一个开放螺旋绕圈，其限定多边形内容积，所述多边形内容积通过在所述至少一个开放螺旋绕圈的匝之间的间隙与所述至少一个开放螺旋绕圈之外的区域连通，其中所述多边形内容积定尺寸成接合驱动器。所述锚件还包括：至少一个肋，其设置在所述多边形内容积内并连接到所述至少一个开放螺旋绕圈的至少两个匝，其中所述至少一个肋定尺寸成接合所述驱动器，所述至少一个肋和所述多边形内容积的组合定尺寸成提供驱动所述锚件进入骨骼中所需的锚件驱动扭矩。
在此所述的任何实施例可包括一个或多个以下实施例。在一些实施例中，所述多边形内容积还包括横截面形状，该横截面形状包括规则多边形、不规则多边形、正方形、矩形、三角形、六边形、和/或八边形中的至少一种。在一些实施例中，所述至少一个肋包括：位于所述多边形内容积的第一侧上的第一肋，和位于所述多边形内容积的第二侧上的第二肋。在一些实施例中，所述的锚件还包括：缝线桥，其附接到所述锚件的远端并设置在该远端内。在一些实施例中，所述至少一个开放螺旋绕圈是双头螺旋绕圈。
在另一方面，在此描述的至少一个实施例提供一种组织修复系统。所述系统包括：驱动器，其包括手柄和连接到该手柄的多边形杆，所述多边形杆的至少一部分具有多边形横截面，所述多边形杆包括远端，该远端具有朝向所述多边形杆的近端延伸的至少一个槽。所述系统还包括：锚件，其能够与所述驱动器的远端接合。所述锚件包括：至少一个开放螺旋绕圈，其限定多边形内容积，所述多边形内容积通过在所述至少一个开放螺旋绕圈的匝之间的间隙与所述至少一个开放螺旋绕圈之外的区域连通，其中所述多边形内容积定尺寸成接合所述驱动器的多边形杆。所述锚件还包括：至少一个肋，其设置在所述多边形内容积内并连接到所述至少一个开放螺旋绕圈的至少两个匝，其中所述至少一个肋定尺寸成接合所述驱动器的所述至少一个槽，所述至少一个肋和所述多边形内容积的组合定尺寸成提供所述驱动器驱动所述锚件进入骨骼中所需的锚件驱动扭矩。
在此描述的用于组织修复的锚件和系统（在下文中称为“技术”）可提供一个或多个下述优点。所述技术的一个优点在于：通过包括多边形内容积和构形减小的驱动器肋，可提供较小的开放构造锚件。多边形内容积和构形减小的驱动器肋的组合可有利地分布扭转驱动力，由此，即使构形减小的驱动器肋具有减小的尺寸和载荷能力，也可在锚件插入骨骼的过程中保持结构完整性。构形减小的驱动器肋有利地允许更小的开放构造锚件保持足够大的内部缝线通路，以使一个或多个缝线通过。所述技术的开放构造有利地允许骨长入，由此减少患者康复时间。减小开放构造尺寸有利地保持骨存量，由此保持骨完整性并减少患者康复时间。减小开放构造尺寸还有利地允许所用的锚件直径相对于螺纹深度具有更高的百分比，由此提高锚件在骨骼中的固定强度。
通过在下文中提供的详细描述，本公开的进一步的应用领域将变得明显。应理解的是，提供详细描述和具体示例的目的仅在于例示，而不是用于限制本公开的范围。
附图说明
通过以下对附图中所示实施例的更具体描述，本发明的前述和其它的目的、特征和优点将显现，在附图中，相同/相似的附图标记在不同图中总是表示相同的部件。附图不必按照比例，而是着重于例示各实施例的原理、特性和特征。在附图中：
图1A是根据各种实施例的示例性开放构造锚件的近端的端视图。
图1B是根据各种实施例的图1的示例性开放构造锚件的等距视图。
图1C是根据各种实施例的图1的示例性开放构造锚件的第二等距视图。
图2A和2B是根据各种实施例的替代性开放构造锚件的多边形内容积的横截面图，其中为了清楚而省略肋。
图3A是根据各种实施例的示例性锚件驱动器的等距视图。
图3B和3C是根据各种实施例的图3A的示例性锚件驱动器的替代性远端的横截面图。
图4是根据各种实施例的示例性组织固定系统的等距视图。
具体实施方式
以下对示例的描述绝不是用以限制本公开、其应用或使用。
图1A－1C显示出锚件100的示例包括至少一个（开放）螺旋螺丝螺纹105。螺旋螺丝螺纹105限定多边形内容积110（例如，如图所示为六边形）。多边形内容积110通过在螺旋螺丝螺纹105匝（turns）之间的间隙115与至少一个开放螺旋绕圈螺丝105之外的区域连通。多边形内容积110接合于锚件驱动器的对应的多边形杆（例如，如图3A－3B中所示的锚件驱动器300的多边形杆301）。
在使用中，锚件100位于锚件驱动器的远端，使得多边形杆接合于锚件100的多边形内容积。扭转驱动力然后通过锚件驱动器施加于锚件100以将锚件100插入到骨骼中。在各种实施例中，锚件驱动器可仅沿锚件纵向长度（即，从近端130a至远端130b）的一部分接合于多边形内容积110。根据各种实施例，锚件驱动器接合于多边形内容积110的几乎整个长度可以是有利的，这是因为，在插入过程中施加于锚件100的扭转驱动力可在锚件100的整个长度上分布，而不是集中在锚件100的较小部分上。在锚件100插入骨骼中且患者开始恢复健康之后，新的骨骼通过间隙115生长到内容积110中。为了更快更完全地恢复健康，这种“骨长入（bonyingrowth）”是非常希望的。
在另一实施例中，锚件100还包括至少一个肋120（例如显示为两个），肋120连接到螺旋螺丝螺纹105的至少两个匝。肋120接合于锚件驱动器的对应槽（例如如图3A－3B中所示的锚件驱动器300的槽305）。在使用中，锚件100位于锚件驱动器的远端，使得槽接合于锚件100的肋120。在各种实施例中，医生使用锚件驱动器将锚件100插入到骨骼中，其中将扭转驱动力施加于驱动器，驱动器将扭力传递到锚件100，由此将锚件拧入骨骼中。
在各种实施例中，锚件驱动器与锚件100的多边形内容积110和肋120的接合有利地将扭转驱动力在肋120与多边形内容积110之间分配。在各种实施例中，这样的载荷分布将允许锚件100承受住扭转驱动力，即使驱动器肋120的尺寸较小。例如，在宽度（w）和/或高度（h）上过小而无法独立支撑扭转驱动力的肋120可以与多边形内容积110结合使用以实现锚件100的必要结构性能。在各种实施例中，锚件驱动器可仅沿锚件纵向长度（即，从近端130a到远端130b）的一部分接合多边形内容积110和/或肋120。不过，根据各种实施例，由锚件驱动器接合多边形内容积110和/或肋120的几乎整个长度可以是有利的，这是因为，在插入过程中施加于锚件100的扭转驱动力可在锚件100的整个长度上分布，而不是集中在锚件100的较小部分上。这种进一步的分布允许在宽度（w）和/或高度（h）上进一步减小。在各种实施例中，宽度（w）和/或高度（h）减小可有利地防止多边形内容积110的横截面区域堵塞，从而使缝线可穿入锚件100和/或锚件驱动器内。
在各种实施例中，锚件100还可包括：缝线桥140，其附接到锚件100的远端130b并至少部分地设置在远端130b内。缝线桥140可完全位于锚件100的远端130b内（例如，如图1B中所示），不过也可以从远端130b中向远侧突出。在各种实施例中，缝线桥140可包括圆滑的面向远侧（distal-facing）区域，围绕该区域可布线（route）一个或多个缝线。在这样的实施例中，每个缝线的第一端在缝线桥的第一侧140a上向近侧延伸穿过锚件100，每个缝线的第二端在缝线桥的第二侧140b上向近侧延伸穿过锚件100。缝线桥140有利地将一个或多个缝线保持在锚件100内，而同时防止与在锚件100与骨骼之间定位所述缝线相关联的对所述缝线的切断、挤压（pinching）、和/或其它削弱。
锚件100的一些示例包括采用“双头”螺纹结构的两个螺旋螺丝螺纹105。双头意味着两个“脊”卷绕锚件100。示例性地但非限制性地，锚件100可以通过聚合物（例如聚醚醚酮）、生物可吸收材料、金属（例如医用级钢、钛）、或任何其它适合的材料构建。
如图1A、2A、2B中所示，根据各种实施例，任意的规则多边形或不规则多边形的形状可用于锚件100、200、250的相应的多边形内容积110、210、260。多边形内容积110、210、260的形状可以示例性地但非限制性地包括：六边形（例如图1A中所示内容积110的形状）、矩形（例如图2A中所示内容积210的形状）、八边形（例如图2B中所示内容积260的形状）、三角形、星形、梯形、和/或任何其它适合的非圆形形状，以能够与驱动器接合以接纳至少一部分的传递的扭转驱动力。
图3A－3C显示出根据各种实施例的锚件驱动器300。锚件驱动器包括在近端处连接到手柄303的多边形杆301。多边形杆301包括朝向多边形杆301的近端延伸的一个或多个槽305（例如显示出两个）。多边形杆301在各种实施例中可沿其整个纵向长度具有多边形横截面。在各种实施例中，多边形杆301可仅沿其纵向长度的一部分具有多边形横截面，并可沿其纵向长度的一个或多个另外的部分具有至少一种不同的横截面形状（例如，不同的多边形、圆形、椭圆形）。
如图3B中所示，一个或多个槽305可在各种实施例中被设为切除槽305a，其向多边形杆301的内部开放。如图3C中所示，一个或多个槽305在各种实施例中可被设为通道槽305b。如前所述，在各种实施例中，多边形杆301可插入锚件（例如前述的100）的多边形内容积（例如前述的110）中，从而使多边形杆301与多边形内容积接合以及使槽305与肋（例如前述的120）接合。
在各种实施例中，手柄303可通过聚合物材料制成，并可通过注射成型工艺制成。不过，也可使用任何其它适合的材料（例如金属、复合材料、木材）和/或工艺（例如挤出、机加工、电－化学加工）。多边形杆301和/或限定其上之槽305的任何表面可由金属材料通过挤出或拉拔工艺制成。不过，也可使用任何其它适合的材料（例如塑料、复合材料）和/或工艺（例如注射成型、铸造、机加工、电－化学加工）。多边形杆301可通过过盈配合联接到手柄303。不过，也可使用任何其它适合的联接方式（例如螺丝、粘接剂、铆钉）。
图4例示出根据各种实施例的组织固定系统400。组织固定系统400包括与驱动器430接合的锚件410。在各种实施例中，一个或多个缝线（未示出）可安装为使得：每个缝线围绕缝线桥（例如图1中所示的140）经过，且每个缝线的端部朝向组织固定系统400的近端延伸穿过锚件410、锚件驱动器430的带槽的多边形杆401、和/或锚件驱动器430的手柄403。在各种实施例中，医生可将扭转驱动力施加到手柄403上，手柄403将扭转驱动力传递到带槽的多边形杆401，由此将扭转驱动力施加于锚件410，以将锚件410拧到骨骼中。在各种实施例中，锚件410可示例性地但非限制性地包括：如上文中参照图1A－1C和图2A－2B所述的任何锚件100、200、250。在各种实施例中，锚件驱动器430、手柄403、和/或带槽的多边形杆401可示例性地但非限制性地包括：如上文中参照图3A－3C所述的任何锚件驱动器300、任何多边形杆301、任何槽305、305a、305b、和/或任何手柄303。
由于在不背离本发明范围的情况下可在本文所述和所示的结构和方法中进行各种修改，因而用意在于：以上描述中所包含的或附图中所显示的所有内容应被理解为是示例性的而不是限制性的。这样，本发明的涵盖范围应不限于任意前述示例，而是应仅根据随后所附权利要求书及其等同方案限定。

Claims (6)

1.一种锚件，包括：
至少一个开放螺旋绕圈，其限定多边形内容积，所述多边形内容积通过在所述至少一个开放螺旋绕圈的匝之间的间隙与所述至少一个开放螺旋绕圈之外的区域连通，其中所述多边形内容积定尺寸成接合驱动器；和
至少一个肋，其设置在所述多边形内容积内并连接到所述至少一个开放螺旋绕圈的至少两个匝，其中，所述至少一个肋定尺寸成接合所述驱动器，所述至少一个肋和所述多边形内容积的组合定尺寸成提供将所述锚件驱动进入骨骼中所需的锚件驱动扭矩。
2.如权利要求1所述的锚件，其中，
所述多边形内容积还包括含规则多边形、不规则多边形、椭圆形、正方形、矩形、三角形、六边形、和/或八边形中的至少一种的横截面形状。
3.如权利要求1所述的锚件，其中，
所述至少一个肋包括：位于所述多边形内容积的第一侧上的第一肋，和位于所述多边形内容积的第二侧上的第二肋。
4.如权利要求1所述的锚件，还包括：
缝线桥，其附接到所述锚件的远端并设置在该远端内。
5.如权利要求1所述的锚件，其中，
所述至少一个开放螺旋绕圈是双头螺旋绕圈。
6.一种组织修复系统，包括：
驱动器，其包括手柄和连接到该手柄的多边形杆，所述多边形杆的至少一部分具有多边形的横截面，所述多边形杆包括远端，该远端具有朝向所述多边形杆的近端延伸的至少一个槽；和
锚件，其能够与所述驱动器的远端接合，包括：
　　至少一个开放螺旋绕圈，其限定多边形内容积，所述多边形内容积通过在所述至少一个开放螺旋绕圈的匝之间的间隙与所述至少一个开放螺旋绕圈之外的区域连通，其中所述多边形内容积定尺寸成接合所述驱动器的多边形杆；和
　　至少一个肋，其设置在所述多边形内容积内并连接到所述至少一个开放螺旋绕圈的至少两个匝，其中所述至少一个肋定尺寸成接合所述驱动器的所述至少一个槽，所述至少一个肋和所述多边形内容积的组合定尺寸成提供所述驱动器将所述锚件驱动进入骨骼中所需的锚件驱动扭矩。
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US20160120534A1 (en) 2016-05-05
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US20140277130A1 (en) 2014-09-18
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JP2016511100A (ja) 2016-04-14
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US9788828B2 (en) 2017-10-17
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