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 relaxationInfo
- 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- Withdrawn
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
Description
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.
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 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.
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)
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 |
Family
ID=6429577
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)
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)
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 |
-
1991
- 1991-04-13 DE DE4112205A patent/DE4112205A1/en not_active Withdrawn
Patent Citations (2)
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)
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 |