WO2000023005A1 - Artificial ligament or biological tissue fixation devices - Google Patents

Artificial ligament or biological tissue fixation devices Download PDF

Info

Publication number
WO2000023005A1
WO2000023005A1 PCT/GB1999/003475 GB9903475W WO0023005A1 WO 2000023005 A1 WO2000023005 A1 WO 2000023005A1 GB 9903475 W GB9903475 W GB 9903475W WO 0023005 A1 WO0023005 A1 WO 0023005A1
Authority
WO
WIPO (PCT)
Prior art keywords
lengths
flat elongate
elongate array
length
tows
Prior art date
Application number
PCT/GB1999/003475
Other languages
French (fr)
Inventor
Michael Antony Sydee Mowbray
Original Assignee
Surgicraft Limited
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 Surgicraft Limited filed Critical Surgicraft Limited
Priority to AU62235/99A priority Critical patent/AU6223599A/en
Publication of WO2000023005A1 publication Critical patent/WO2000023005A1/en

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

Definitions

  • This invention relates to artificial ligament or biological tissue fixation devices, e.g., ligament augmentation devices such as are used for reinforcing or supplementing damaged ligaments while healing takes place or for use in conjunction with autologous grafts for reconstructing torn ligaments, such as the anterior cruciate ligament (ACL) or artificial ligaments per se for delivery devices for autologous grafts.
  • ligament augmentation devices such as are used for reinforcing or supplementing damaged ligaments while healing takes place or for use in conjunction with autologous grafts for reconstructing torn ligaments, such as the anterior cruciate ligament (ACL) or artificial ligaments per se for delivery devices for autologous grafts.
  • ACL anterior cruciate ligament
  • Such devices are described in WO94/22395 as being manufactured by securing a plurality of tows of biocompatible material (e.g. polyester) side-by-side in a flat elongate array, as by light braiding, looping the tows back at one end (or both ends) of the device to form an eye (or an eye at both ends), and applying lashing around the base of the eye (or eyes), which is available for attachment of a pulling cord or wire and/or for secure fixing of that end of the device by fitting the eye round an anchor member secured to a bone.
  • biocompatible material e.g. polyester
  • WO94/22395 also describes the lengths of flat elongate array being secured side-by-side by stitching, and also applying whipping around grouped tows around the eye.
  • Such a device having an eye at one end can have its stitched-together side-by-side lengths
  • a major disadvantage is the excessive distance between the fixation points on the tibia and the femur. This distance leads to low initial graft stiffness and allows micromotion of the graft in the bone tunnels in the femur and tibia, called the "bungee" effect, which could potentially cause adverse healing and/or failure of the graft.
  • an artificial ligament device comprises a plurality of tows of biocompatible material secured side-by-side in a flat elongate array, looped back at both ends to form an eye at both ends, with lashing around the bases of the eyes, characterized in that the lengths of flat elongate array are secured side-by-side at intervals, thus forming "button-holes".
  • ACL reconstruction the end portions of an autologous graft are fed through
  • buttons-holes towards each end of the device and then sutured to the device, and a mid-section of the device is cut out to leave purely autologous tissue to serve as the replacement ACL.
  • use of the device alone as an artificial ligament per se is not precluded.
  • the device is preferably made of polyester as it attracts vigorous tissue ingrowth, which provides further strengthening of the fixation with time, compared with largely inert mechanical
  • fixation devices currently in clinical use, and allows unobstructed X-ray and MRI images.
  • the device is preferably available in different lengths to suit the requirements of individual patients.
  • the free ends of the flat elongate array preferably meet at the middle of a mid-section of
  • the device and are stitched to each other, and the mid-section of the device may be defined by a length in which the lengths of flat elongate array are not secured to each other over a length appreciably longer than the length of a "button-hole".
  • Figure 2 is a view of the device as seen from the left hand side of Figure 1;
  • Figure 3 corresponds generally to Figure 2 but shows an autologous graft fed through "button-holes" towards each end of the device; and
  • Figure 4 corresponds to Figure 3 but also shows the graft after it has ben sutured to the
  • an artificial ligament device 10 comprises a plurality of tows 11 of biocompatible material, such as polyester, secured side-by-side in a flat elongate array, as by braiding 12, the array being looped back at both ends to form an eye 13 at both ends, with lashing
  • the flat elongate array is simply folded over to form the eyes 13 and then one of the lengths 16, 17 twisted through 180° to bring that length into the same plane as and alongside the other length.
  • the lengths 16, 17 (the latter of which includes the stitched-together ends 15) are secured side-by-side, as by stitching 18 extending all the way
  • a mid-section 20 of the device being defined by a length in which the lengths 16, 17 of flat elongate array are
  • the eyes 13 are available for fitting round anchor members at fixation points on, for example, the tibia and the femur, and one of the eyes may be provided with a pulling cord or tape or a wire (not shown) for threading one end of the device and graft through a bone tunnel.

Abstract

An artificial ligament device (10) comprising a plurality of tows (11) of biocompatible material secured side-by-side in a flat elongate array, looped back at both ends to form an eye (13) at both ends, with lashing (14) around the bases of the eyes, characterized in that the lengths (16, 17) of the flat elongate array are secured side-by-side at intervals (18), thus forming 'button-holes' (19). In use for ACL reconstruction, the end portions (21) of an autologous graft (22) are fed through 'button-holes' (19) towards each end of the device (10) and then sutured (at 23) to the device, and a mid-section (20) of the device is cut out to leave purely autologous tissue to serve as the replacement ACL. However, use of the device (10) alone as an artificial ligament per se is not precluded.

Description

ARTIFICIAL LIGAMENT OR BIOLOGICAL TISSUE FIXATION DEVICES
This invention relates to artificial ligament or biological tissue fixation devices, e.g., ligament augmentation devices such as are used for reinforcing or supplementing damaged ligaments while healing takes place or for use in conjunction with autologous grafts for reconstructing torn ligaments, such as the anterior cruciate ligament (ACL) or artificial ligaments per se for delivery devices for autologous grafts.
Such devices are described in WO94/22395 as being manufactured by securing a plurality of tows of biocompatible material (e.g. polyester) side-by-side in a flat elongate array, as by light braiding, looping the tows back at one end (or both ends) of the device to form an eye (or an eye at both ends), and applying lashing around the base of the eye (or eyes), which is available for attachment of a pulling cord or wire and/or for secure fixing of that end of the device by fitting the eye round an anchor member secured to a bone.
WO94/22395 also describes the lengths of flat elongate array being secured side-by-side by stitching, and also applying whipping around grouped tows around the eye. Such a device having an eye at one end can have its stitched-together side-by-side lengths
of flat elongate array wrapped round one end of an autologous graft, with the mating edges stitched together to form a sleeve over that end of the graft and stitched thereto, whereby the device can serve as a delivery device for the graft. The other end of the autologous graft may
be similarly treated.
In recent years, hamstring grafts have been advocated for ACL reconstruction due mainly to the reduced morbidity associated with the harvesting procedure. In laboratory testing, a quadrupled hamstring graft was shown to have equal or greater strength than a bone-patellar tendon-bone graft. A problem, however, is that all previous fixation techniques have been less
effective. A major disadvantage is the excessive distance between the fixation points on the tibia and the femur. This distance leads to low initial graft stiffness and allows micromotion of the graft in the bone tunnels in the femur and tibia, called the "bungee" effect, which could potentially cause adverse healing and/or failure of the graft.
An object of the present invention is to alleviate this problem. According to the present invention, therefore, an artificial ligament device comprises a plurality of tows of biocompatible material secured side-by-side in a flat elongate array, looped back at both ends to form an eye at both ends, with lashing around the bases of the eyes, characterized in that the lengths of flat elongate array are secured side-by-side at intervals, thus forming "button-holes". In use for ACL reconstruction, the end portions of an autologous graft are fed through
"button-holes" towards each end of the device and then sutured to the device, and a mid-section of the device is cut out to leave purely autologous tissue to serve as the replacement ACL. However, use of the device alone as an artificial ligament per se is not precluded.
The device is preferably made of polyester as it attracts vigorous tissue ingrowth, which provides further strengthening of the fixation with time, compared with largely inert mechanical
fixation devices currently in clinical use, and allows unobstructed X-ray and MRI images.
The device is preferably available in different lengths to suit the requirements of individual patients.
The free ends of the flat elongate array preferably meet at the middle of a mid-section of
the device and are stitched to each other, and the mid-section of the device may be defined by a length in which the lengths of flat elongate array are not secured to each other over a length appreciably longer than the length of a "button-hole".
The securing together of the lengths of flat elongate array may be effected by stitching
extending all the way across both lengths. The tows may be grouped around each eye and whipping may be applied around the grouped tows; however, it may suffice to simply fold the flat elongate array over to form the eyes, and then twist one of the lengths through 180° adjacent to the eyes to bring that length into the same plane as and alongside the other length. An embodiment of the invention and its manner of use will now be described, by of example only, with reference to the accompanying drawings, in which:- Figure 1 is an elevation of the device;
Figure 2 is a view of the device as seen from the left hand side of Figure 1; Figure 3 corresponds generally to Figure 2 but shows an autologous graft fed through "button-holes" towards each end of the device; and
Figure 4 corresponds to Figure 3 but also shows the graft after it has ben sutured to the
device and a mid-section of the device has been cut out.
In Figures 1 and 2 an artificial ligament device 10 comprises a plurality of tows 11 of biocompatible material, such as polyester, secured side-by-side in a flat elongate array, as by braiding 12, the array being looped back at both ends to form an eye 13 at both ends, with lashing
14 around the bases of the eyes, and with the free ends 15 of the flat elongate array meeting at the
middle of the device and being stitched to each other. The flat elongate array is simply folded over to form the eyes 13 and then one of the lengths 16, 17 twisted through 180° to bring that length into the same plane as and alongside the other length. In accordance with the present invention, the lengths 16, 17 (the latter of which includes the stitched-together ends 15) are secured side-by-side, as by stitching 18 extending all the way
across both lengths, at intervals, thus forming "button-holes" 19 towards each end, a mid-section 20 of the device being defined by a length in which the lengths 16, 17 of flat elongate array are
not secured to each other over a length appreciably longer than the length of a "button-hole". In Figure 4 end portions 21 of an autologous graft 22 are fed through "button-holes" 19 towards respective ends of the device 10 and then sutured to the device as indicated at 23 in Figure 4, after which the mid-section 20 of the device is cut out to leave purely autologous tissue to serve as, for example, a replacement ACL; however, use of the device 10 above as an artificial ligament per se is not precluded.
The eyes 13 are available for fitting round anchor members at fixation points on, for example, the tibia and the femur, and one of the eyes may be provided with a pulling cord or tape or a wire (not shown) for threading one end of the device and graft through a bone tunnel..

Claims

1. An artificial ligament device ( 10) comprising a plurality of tows ( 11 ) of biocompatible material secured side-by-side in a flat elongate array, looped back at both ends to form an eye (13) at both ends, with lashing (14) around the bases of the eyes, characterized in that the lengths (16, 17) of the flat elongate array are secured side-by-side at intervals (18), thus forming "buttonholes" (19).
2. A device (10) as in Claim 1, characterized in that it is formed of polyester.
3. A device as in Claim 1 or Claim 2, characterized in that the free ends (15) of the flat elongate array meet at the middle of a mid-section (20) of the device (10) and are stitched to each other.
4. A device as in Claim 3, characterized in that the mid-section (20) of the device (10) is defined by a length in which the lengths (16, 17) of flat elongate array are not secured to each other over a length appreciably longer than the length of a "button-hole" (19).
5. A device as in any one of Claims 1 to 4, characterized in that the securing together of the lengths (16, 17) of flat elongate array is effected by stitching (18) extending all the way across the lengths.
6. A device as in any one of Claims 1 to 5, characterized in that the tows (11) are secured side-by-side by braiding (12).
7. A device as in any one of Claims 1 to 6, characterized in that the tows (11) are
grouped around each eye (13) and whipping is applied around the grouped tows.
8. A device as in any one of Claims 1 to 6, characterized in that the flat elongate array is folded over to form the eyes (13), and then one of the lengths (16, 17) is twisted through 180°
adjacent to the eyes to bring that length into the same plane as and alongside the other length.
PCT/GB1999/003475 1998-10-20 1999-10-20 Artificial ligament or biological tissue fixation devices WO2000023005A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU62235/99A AU6223599A (en) 1998-10-20 1999-10-20 Artificial ligament or biological tissue fixation devices

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB9822775.4A GB9822775D0 (en) 1998-10-20 1998-10-20 Artificial ligament or biological tissue fixation devices
GB9822775.4 1998-10-20

Publications (1)

Publication Number Publication Date
WO2000023005A1 true WO2000023005A1 (en) 2000-04-27

Family

ID=10840824

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1999/003475 WO2000023005A1 (en) 1998-10-20 1999-10-20 Artificial ligament or biological tissue fixation devices

Country Status (3)

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AU (1) AU6223599A (en)
GB (2) GB9822775D0 (en)
WO (1) WO2000023005A1 (en)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8574296B2 (en) * 2011-03-31 2013-11-05 Biomet Manufacturing Corporation Dual tendon bundle
GB201113303D0 (en) 2011-08-02 2011-09-14 Xiros Ltd Connective tissue repair pad
EP2739241B1 (en) * 2011-08-02 2017-09-06 Xiros Limited Connective tissue repair
GB201301784D0 (en) 2013-02-01 2013-03-20 Xiros Ltd Connective tissue repair technology

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3805300A (en) * 1972-07-28 1974-04-23 Cutter Lab Tendon prosthesis
US4642119A (en) * 1984-07-16 1987-02-10 Johnson & Johnson Connective tissue prosthesis
US4662886A (en) * 1984-06-04 1987-05-05 A. W. Showell (Surgicraft) Limited Surgical element
EP0260787A1 (en) * 1986-07-23 1988-03-23 W.L. Gore & Associates, Inc. Mechanical Ligament
US5192322A (en) * 1990-01-08 1993-03-09 Sulzer Brothers Limited Implant for a prosthetic ligament and/or tendon replacement
WO1994022395A1 (en) 1993-03-31 1994-10-13 Surgicraft Limited Artificial ligament
FR2729559A1 (en) * 1995-01-25 1996-07-26 Cousin Freres Sa Textile ligament reinforcement, esp. for knee joint
FR2768612A1 (en) * 1997-09-24 1999-03-26 Jmed Sarl Artificial ligament

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2151487A (en) * 1983-12-15 1985-07-24 Showell A W Replacements for ligaments and tendons
US5197983A (en) * 1988-04-19 1993-03-30 W. L. Gore & Associates, Inc. Ligament and tendon prosthesis

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3805300A (en) * 1972-07-28 1974-04-23 Cutter Lab Tendon prosthesis
US4662886A (en) * 1984-06-04 1987-05-05 A. W. Showell (Surgicraft) Limited Surgical element
US4642119A (en) * 1984-07-16 1987-02-10 Johnson & Johnson Connective tissue prosthesis
EP0260787A1 (en) * 1986-07-23 1988-03-23 W.L. Gore & Associates, Inc. Mechanical Ligament
US5192322A (en) * 1990-01-08 1993-03-09 Sulzer Brothers Limited Implant for a prosthetic ligament and/or tendon replacement
WO1994022395A1 (en) 1993-03-31 1994-10-13 Surgicraft Limited Artificial ligament
FR2729559A1 (en) * 1995-01-25 1996-07-26 Cousin Freres Sa Textile ligament reinforcement, esp. for knee joint
FR2768612A1 (en) * 1997-09-24 1999-03-26 Jmed Sarl Artificial ligament

Also Published As

Publication number Publication date
GB9924676D0 (en) 1999-12-22
GB2342865B (en) 2002-10-30
GB9822775D0 (en) 1998-12-16
AU6223599A (en) 2000-05-08
GB2342865A (en) 2000-04-26

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