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WO2024184364A1 - Dispositif de tension de ligament - Google Patents

Dispositif de tension de ligament Download PDF

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Publication number
WO2024184364A1
WO2024184364A1 PCT/EP2024/055752 EP2024055752W WO2024184364A1 WO 2024184364 A1 WO2024184364 A1 WO 2024184364A1 EP 2024055752 W EP2024055752 W EP 2024055752W WO 2024184364 A1 WO2024184364 A1 WO 2024184364A1
Authority
WO
WIPO (PCT)
Prior art keywords
ligament
holder
tensioning device
end section
interconnected
Prior art date
Application number
PCT/EP2024/055752
Other languages
English (en)
Inventor
Robert Frigg
Jonas WIDMER
Mazda Farshad
Original Assignee
Moving Spine Ag
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 Moving Spine Ag filed Critical Moving Spine Ag
Publication of WO2024184364A1 publication Critical patent/WO2024184364A1/fr

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Classifications

    • 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
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7002—Longitudinal elements, e.g. rods
    • A61B17/7019—Longitudinal elements having flexible parts, or parts connected together, such that after implantation the elements can move relative to each other
    • A61B17/7022—Tethers, i.e. longitudinal elements capable of transmitting tension only, e.g. straps, sutures or cables
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8869—Tensioning devices
    • 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
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B2017/0496—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures

Definitions

  • the present disclosure relates to a ligament tensioning device for tensioning ligaments in particular allograft or autograft ligaments in the field of semi-rigid spine stabilization and the like.
  • WO21071968A1 was first published in April 2021 on behalf of Ortho Dev Corp. It is directed to a tether tensioning instrument to tension and/or lock a tether about a spinal feature to assist in spinal fixation.
  • the instrument may comprise a handle, a tensioner base coupled with the handle, at least a portion thereof being movably coupled to the handle.
  • a tether coupling member coupled with the tensioner base and configured to fixedly engage a tether.
  • the instrument may further comprise a tensioner tip movably coupled with the tensioner base, wherein at least a portion of the tensioner base is biased away from the tensioner tip.
  • the instrument is configured to allow for step wise movement of the tensioner tip away from the tensioner base to increase tension between the tether and an element of the spinal fixation system.
  • EP3618743A1 was first published in November 2021 on behalf of Cousin Biotech. It relates to an accessory for tensioning an elongate element for attaching an implant to a bone element.
  • the accessory comprises a device for tensioning the elongate element comprising a drum.
  • the drum comprising a holding portion suitable for cooperating with the elongate element.
  • Said tensioning device comprises a device for rotating the drum about the axis T, allowing the elongate element to be tensioned by winding the elongate element around the drum.
  • US11344337B2 was first published in August 2019 on behalf of Zimmer Biomed Spine Inc. It relates to devices and systems for attenuation of increased spinal flexion loads post-fusion that include a transition member.
  • the transition member may have a tension component coupleable to a fused vertebra of a plurality of fused vertebra of a fusion implant and to an adjacent unfused vertebra.
  • the tension component may be tensionable to a selected value.
  • the tension component may modulate a flexion range of motion of the adjacent unfused vertebra as a function of the selected value of tension of the tension component.
  • the transition member may attenuate spinal flexion loads on adjacent unfused vertebra post- operatively.
  • WO16116692A1 was first published in July 2016 on behalf of Implanet. It relates to a device for attaching a flat and flexible band on at least one bone part.
  • the band having two end portions.
  • a rigid base body comprises an opening and a retaining part that can be inserted in the opening.
  • the retaining part is at least partially in the shape of a squeezable wedge comprising a central bore for passage of the end portions facing the flexible band.
  • the bore having a transverse cross-section that can be deformed between a first cross-section for free passage of the end portions when the part has not been inserted in the opening and a second cross-section for locking the end portions by compression when the part is entirely or substantially entirely inserted in the opening.
  • CN204364111 U was first published in June 2015.
  • the cable tightening device comprises a barrel, a trigger and a grip.
  • a front barrel body is arranged at the front end of the barrel, a front cable penetrating channel is formed in the front barrel body. The part, in the front cable penetrating channel, of the cable can be locked by a front cable locking mechanism.
  • a front snap ring and a rear snap ring are arranged in the barrel.
  • a mandrel in the barrel is movably supported in a through hole of the front snap ring and a through hole of the rear snap ring and extends out of the barrel.
  • the cable tightening device can be operated with one hand.
  • W010141086A1 was first published in December 2010 on behalf of Kinamed Inc. It is directed to a surgical cable tensioning system. It includes a reaction frame which contains a sliding platform arranged to move linearly within the frame. A clam-type cleat is attached to the sliding platform. The cleat features one or more grooves, each of which comprises two arrays of opposing ridges that converge to form a V-shape groove adapted to receive a length of cable. The ridges of each groove are tilted relative to an axis perpendicular to the groove's longitudinal axis, such that the cable is progressively captured between the ridges of the opposing arrays as it settles into the crotch of the groove when moved in a first direction. It can be disengaged from the cleat by relaxing the axial force on the cable and moving it in the opposite direction. A linear actuator mechanism may be coupled to the sliding platform to move the platform with respect to the reaction frame.
  • WO06118259A1 was first published in November 201 1 on behalf of Alfresa Pharma Corp. It relates to a cable-tightening device.
  • the device comprises a grip portion, a rod-like member extending forward, a knot-supporting means at the tip, a cable-holding means to grip and hold the tow arms together, and a sliding block mounted around the rod-like member and connected to a pulling means. Further it comprises an operation lever to drive the pulling means.
  • US6582433B2 was first published in October 2022 on behalf of Kyphon Sari. It relates to a device and method that immobilizes the vertebral bodies by immobilizing the respective spinous process extending therefrom.
  • the device contains a spacer extending from a body with the spacer adapted to be positioned between adjacent spinous processes so that the spacer may be located close to the spine.
  • a strap connected with the body is designed to engage the spinous processes, such that the device may be adjusted to be positioned about the spinous processes.
  • the device ensures that the spacer remains positioned between adjacent spinous processes.
  • the method to insert the device minimizes destruction to body tissue, thus it is less traumatic to the patient and allows for the patient to recover from the procedure faster than conventional methods.
  • W09401057A1 was first published in January 1994 on behalf of Erpios Snc. It relates to a prosthesis including a flexible ligament with a first narrowed thinner portion and a second wider portion forming an extension of and having a greater width and thickness than the first portion which portion may be passed around the spinous processesof two adjacent vertebrae in a figure eight pattern. The second portion circles around the processes in a semi-flexible interprocess block with two pairs of through-channels.
  • spinal fusion by rigid metal rods attached to several vertebrae by screws to stabilizing them and if necessary insertion of intervertebral cages is at presence a very common surgical procedure, among others in the treatment of degenerative disorders of the spine.
  • spinal fusion is often associated with serious long-term complications such as adjacent segment degeneration, screw loosening, pseudo arthrosis, implant failure, and, in rare cases, neurovascular injury during implant insertion.
  • Negative redistribution of loads with subsequently increased biomechanical stress are believed to act as accelerators of adjacent segment disease and proximal junctional kyphosis.
  • long fusions can lead to a relevant, irreversible loss of motion, which can cause postural changes.
  • the above problems are successfully addressed in a particular way by a new method of soft spinal stabilization by posterior implementation and fixation of strap like implants in a manner, which does not negatively affect the biomechanics.
  • the strap like implants are preferably in the form of ligaments, preferably autograft or allograft ligaments or artificial ligaments or a combination thereof. It is understood that this also includes xenograft ligaments, as well as implants in the form tendons, including autograft, xenograft allograft tendons or artificial tendons.
  • the implants are arranged in at least one closed loop or a series of parallel and/or intersecting loops entangling two spaced apart components of the skeleton in a patient’s body and are then pretensioned in specific manner before being affixed.
  • the component of the skeleton may e.g. be a vertebra or a rib. If the at least one loop entangles two or more of the same or different components, influence is taken on the resulting load path and load distribution.
  • One difficulty, which occurs with this method is, that the implants which preferably are having a particular stress-strain characteristics, should be installed under an initial tension to bring the operating point of the resulting mechanical system to a defined value.
  • the devices and systems known from the prior art do not offer appropriate measures.
  • the ligament tensioning device With the ligament tensioning device according to the present disclosure, it becomes possible to adjust the biomechanics of the interaction of the implant and the skeleton such that the resulting mobility is close to the natural behavior.
  • the ligament tensioning device allows the application and fixation of an implant in a controlled and gentle manner while the implants are under a specific tension. This is advantageous with respect to load distribution and thereby reduces the problems inherent to the prior art. It has been found that it is of particular importance, that the load level is chosen in biome- chanically appropriate manner.
  • the devices according to the present disclosure are optimized to process natural ligaments and/or artificial ligaments that have similar properties as they offer an interaction zone in which a first end section and the second end section of a ligament may cross each other and/or may be de- fleeted with respect to each other in opposite direction longitudinally.
  • the deflection may result from a deflection of the ligament with respect to itself, respectively each other, when more than one is present, or e.g. by an additional retainer which acts as a linking element.
  • Good results may be achieved when the retainer is ring shaped.
  • the ligament is not mechanically disadvan- tageously stressed.
  • the interconnection in the interaction zone can be established in a gentle and ligament correct manner which improves the ingrowth, durability and healing of the tissue.
  • a ligament tensioning device for tensioning an implant preferably comprises a first holder and a second holder.
  • the first and the second holder are interconnected to a base and configured to during operation temporarily hold a first end section, respectively a second end section of a strap like implant, e.g. in the form of a ligament or an extension attached to or forming part of the ligament in the form of a cord which can be removed at a later stage when not needed any more.
  • a ligament tensioning device for tensioning an implant preferably comprises a first holder and a second holder.
  • the first and the second holder are interconnected to a base and configured to during operation temporarily hold a first end section, respectively a second end section of a strap like implant, e.g. in the form of a ligament or an extension attached to or forming part of the ligament in the form of a cord which can be removed at a later stage when not needed any more.
  • at least one of the first holder or the second holder is arranged displaceable with respect to
  • the ligament tensioning device further comprises an interaction zone in which during operation the first end section and the second end section of the ligament cross each and/or are redirected with respect to each other in opposite direction longitudinally, suitable to be interconnected to each other in the area of crossing and/or pass through a retainer (fastener) by which they can be interconnected to each other indirectly.
  • the ligament tensioning device may comprise at least one idler in the direction of the ligament usually arranged before at least one of the first or the second holder. The at least one idler redirects the ligament during operation and feeds it to the holder.
  • the ligament tensioning device preferably comprises a dynamometer to determine the total force applied to the ligament in the area of the interaction zone.
  • the dynamometer may be configured to precisely indicate the total force on a scale and/or comprise a force limiter, which limits the force applied to the ligament to a certain level.
  • the force limiter may be fixed or adjustable, if appropriate. Good results can be achieved when the force limiter comprises an overload clutch that disengages when the force applied to the ligament reaches a predetermined level.
  • the overload clutch preferably disengages at a force level in the range of 40N to 100N, more particular at a force level in the range of 60N to 80N, more particular in the range of 65N to 75N.
  • the overload clutch may disengage at a force level in the range of 40N to 250N, more particular at a force level in the range of 60 N to 200 N.
  • the ligament tensioning device may comprise a linear guide device and/or a rotation guide device or a combination thereof, by which the first and the second holder can be displaced relative to each other and/or relative to the base to tension the ligament during process.
  • the ligament tensioning device can be designed such that the length of the interaction zone is adjustable.
  • the ligament tensioning device may optionally further comprise a third holder interconnected to the base and configured to during operation temporarily hold a ligament connector for interconnecting the first end section and the second end section of the ligament in the interaction zone.
  • the ligament connector may optionally be releasably engaged with the third holder before the operation. During the operation, the ligament connector may then be interconnected to the first end section and the second end section of the ligament in the interaction zone.
  • the third holder may be arranged between the first holder and the second holder or, if present, between the idlers.
  • the third holder may further be configured to during operation temporarily hold one or more suture carriers each comprising an opening for holding at least one suture forming a plurality of loops for encompassing the first end section and/or the second end section of the ligament.
  • the one or more suture carriers may be separate pieces, e.g. separate from the ligament tensioning device.
  • the one or more suture carriers may be releasably engageable with the third holder. It is understood that the suture may for example comprise a surgical suture, but it may also comprise a cord or string.
  • the ligament tensioning device further comprises a tensioning unit for activating during operation the ligament connector, such that the first end section and the second end section of the ligament are interconnected in the interaction zone.
  • a tensioning unit for activating during operation the ligament connector, such that the first end section and the second end section of the ligament are interconnected in the interaction zone.
  • the ligament connector may be activated through tensioning.
  • the ligament tensioning device may further comprise a suture separator for cutting the at least one suture after interconnection to the first end section and the second end section of the ligament in the interaction zone. It is understood that, depending on the application, the ligament tensioning device may be provided together with or separately from the at least one suture that forms a plurality of loops for encompassing the first end section and/or the second end section of the ligament.
  • the ligament tensioning device comprises the at least one suture forming a plurality of loops.
  • the plurality of loops may for example be arranged displaceable with respect to the one or more suture carriers.
  • different carriers may be used.
  • the carrier has a bore for receiving the at least one suture and for receiving the first end section and/or the second end section of the ligament.
  • the carrier may have different shapes.
  • the carrier may be tubular.
  • the carrier may have a C-shaped cross section and may comprise a slit extending in longitudinal direction of the carrier.
  • the carrier may comprise a predetermined breaking point.
  • the third carrier may comprise one or more carriers.
  • the third carrier comprises a first suture carrier for holding a first suture forming a plurality of loops for encompassing the first end section of the ligament, and the third carrier further comprises a second suture carrier for holding a second suture forming a plurality of loops for encompassing the second end section of the ligament.
  • Fig. 1 a first variation of a ligament tensioning device according to the pre- sent disclosure in a perspective view from the front and above;
  • FIG. 2 the first variation of a ligament tensioning device according to Figure 1 in a perspective view from the behind and above;
  • FIG. 3 the ligament tensioning device according to Figure 1 in a partially cut view in an untensioned, retracted position
  • Fig. 4 the ligament tensioning device according to Figure 1 in a partially cut view in a tensioned, extended position
  • FIG. 6 A second embodiment of a ligament tensioning device in a perspective view from above and the front;
  • Fig. 7 The ligament tensioning device according to Figure 6 in a perspective view from above and behind;
  • Fig. 8 The ligament tensioning device according to Figure 1 in a perspective view from the front and above, including a retainer;
  • Fig. 9 A third embodiment of a ligament tensioning device in a perspective view from above and the front.
  • Figure 1 shows a ligament tensioning device 1 according to the present disclosure in a perspective view from above and the front.
  • Figure 2 is showing the ligament tensioning device 1 in a perspective view from the rear and above.
  • Figure 3 is showing the ligament tensioning device according to Figure 1 in a partially cut view in an untensioned, retracted position.
  • Figure 4 is showing the ligament tensioning device according to Figure 1 in a partially cut view in a tensioned, extended position.
  • Figure 5 is showing detail A according to Figure 4.
  • Figure 6 is showing a second embodiment of a ligament tensioning device 1 in a perspective view from above and the front.
  • Figure 7 is showing the ligament tensioning device according to Figure 6 in a perspective view from above and behind.
  • Figure 8 shows a ligament tensioning device 1 according to Figure 1 in a perspective view from the front and above, including a retainer 40.
  • Figure 9 shows a third embodiment of a ligament tensioning device 1 in a perspective view from above and the front.
  • a ligament 2 e.g. is arranged such that it entangles two components of the skeleton 15 in a patient’s body.
  • the components 15 can e.g. be vertebrae or the like, which are spaced apart by a distance and shall be interconnected to each other in a biomechanically preferably manner.
  • Good results can be achieved with a ligament tensioning device 1 which comprises a first holder 3 interconnected to a base 5 and configured to during the intervention temporarily hold a first end section 6 of a ligament 2.
  • the ligament tensioning device 1 further comprises a second holder 4 interconnected to the base 5 and configured to hold a second end section 7 of the ligament 2.
  • first holder 3 and the second holder 4 are arranged at the end of a first and a second cantilever 16, 17. While the first cantilever 16 is fixedly arranged at a primary guide rod 18 of the base 5, the second cantilever 17 is arranged at a bracket 19 encompassing the primary guide rod 18 and being linearly displaceable along the primary guide rod 18 in an axial direction (x).
  • the bracket 19 comprises an internal thread 20, which is the mounted position engaged with an external thread 21 of a bushing 22.
  • the bushing 22 is rotatable around a rotation axis 30 and in the shown variation, displaceable with respect to the guide rod 18.
  • the bracket 19 is arranged in a non-rotatable manner but linear displaceable with respect to the guide rod 18.
  • a secondary guide rod 31 is fixedly arranged parallel to the primary guide rod 18. It is engaged with a corresponding bore 32 of the bracket 19 and thereto in longitudinal direction thereto displaceable. Thereby it prevents unwanted rotation between the bracket 19 and the primary guide rod 18.
  • the bushing 22 is supported with respect to the guide rod 18 by a first helical spring 23 which, when the first and the second holder 3, 4 are displaced apart from each other in the axial direction (x) by relative rotation of the internal thread 20 with respect to the external thread 21 exceeds a force against the resistance of the ligament 2 interconnected via the first and the second holder 3, 4 to the ligament tensioning device 1 .
  • the rotation is initiated by a knob 24 which is interconnected to the external thread by an overload clutch 25, which acts as a force limited in that it disengages when the force applied to the ligament 2 via the spring 23, exceeds a predefined maximum.
  • the overload clutch comprises a clutch pin 26 which when engaged - as visible in Figure 3 - is arranged in a first slot 27 of the bushing 22 and simultaneously in a second slot 28 of the knob 24 and thereby mechanically engages them to each other in direction of rotation.
  • the clutch pin 26 extends transversely with respect to the first direction (x). It is supported in axial direction by a second helical spring 29 that is arranged inside the knob 24 in a precompressed manner and pushes the pin 26 in the direction of the first spring 23 away from the knob 24.
  • a release pin 33 arranged at the primary guide rod 18 pushes against the clutch pin 26 corre- spending to the compression of the first helical spring 23.
  • the overload clutch can be designed with an adjustable load level for more flexibility.
  • the overload clutch 25 disengages at a force level in the range of 40N to 100N, more particular at a force level in the range of 60N to 80N, more particular in the range of 65N to 75N.
  • other values may be appropriate.
  • the first and the second holder 3, 4 are arranged at the end of the first cantilever and the second cantilever 16, 17. Thereby it becomes possible to place the ligaments close to the structure of the patient.
  • the first and the second holder 3, 4 are spaced a first distance 13 apart from each other defining a length of an interaction zone 8 in which during operation the first end section 6 and the second end section 7 of the ligament 2 may cross each other in opposite direction longitudinally and/or may be deflected with respect to each other, if appropriate by a retainer 40 as schematically shown in Figure 8.
  • the interaction zone 8 is preferably dimensioned in a manner that the first and the second end section 6, 7 of the ligament 2 closely approximate each other.
  • the tension on the ligaments can be adjusted by the linear guide device 14.
  • the opposite end sections 6, 7 of the ligament 2 can be laterally interconnected to each other.
  • the length of the interaction zone 8 is adjustable before tension is exerted onto the ligament 2.
  • the ligament tensioning device 1 comprises a base 5 from which a first and a second cantilever 16, 17 extend perpendicular. While a first holder 3 is arranged at the first cantilever 16 in a non-displaceable manner, a second holder 4 is arranged in a linearly displaceable manner at the second cantilever 17.
  • Each cantilever 16, 17 comprises at its free end an idler 9 by which during operation a ligament 2 can be redirected (deflected) in the direction of the first, respective the second holder 3, 4 after extending across an interaction zone 8.
  • the interaction zone 8 of the present variation is, in difference to the first variation according to Figures 1-5, arranged between the two idlers 9.
  • the idlers 9 can be arranged rotatably to reduce friction.
  • the first and the second end sections 6, 7 of the ligament 2 are attached to the holders 3, 4 while they entangle two components of a skeleton as mentioned herein above.
  • the holders 3 and 4 each comprise a clamp 34 with two opposite clamp jaws 35 between which the respective first and second end sections 6, 7 of the ligament 2 are clamped.
  • a threaded spindle 38 that is interconnected to the second holder 7, the second holder 7 can be displaced along the second cantilever 17. Thereby the ligament can be tensioned.
  • the ligament tensioning device 1 comprises an integrated dynamometer by which the tension force exerted onto the ligament 2 in the interaction zone 8 can be displayed on a scale 39.
  • the first holder and the second holder may for example be arranged such that during operation the first end section and the second end section of the ligament extend essentially in parallel to each other in the interaction zone.
  • the variation of the ligament tensioning device 1 according to Figure 9 is now explained in more detail.
  • the variation of Figure 9 is substantially similar to the variation of Figures 6 and 7, and therefore reference is made to Figures 6 and 7, in particular with respect to the general description and functionality.
  • the embodiment shown in Figure 9 additionally comprises a third holder 41 arranged between the two idlers 9.
  • the third holder 41 is connected to a suture carrier 42, which has a C-shaped cross-section and is arranged in the interaction zone 8.
  • the suture carrier 42 comprises an opening for receiving the first end section 6 and the second end section 7 of the ligament 2.
  • the opening of the suture carrier 42 is also configured for holding a suture forming a plurality of loops (not shown), which may be used for interconnecting the first end section 6 and the second end section 7 in the interaction zone.
  • the suture may form a first hitch and a second hitch, wherein the first hitch may during operation encompass the first end section and the second hitch may during operation encompass the second end section.
  • the embodiment shown in Figure 9 also comprises a tensioning unit 43 for tensioning during operation the suture that interconnects the first end section and the second end section of the ligament.

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Abstract

La divulgation concerne un dispositif de tension de ligament (1) pour tendre un ligament (2) enchevêtrant au moins un composant (15) dans le corps d'un patient pendant une intervention chirurgicale. Le dispositif de tension de ligament (1) comprend un premier support (3) interconnecté à une base (5) et configuré pour maintenir temporairement pendant le fonctionnement une première section d'extrémité (6) du ligament (2). Il comprend en outre un second support (4) interconnecté à la base (5) et configuré pour maintenir temporairement pendant le fonctionnement une seconde section d'extrémité (7) du ligament (2). Au moins l'un du premier support (3) ou du second support (4) peut être déplacé par rapport à la base (3) et/ou l'un à l'autre pour tendre le ligament (2) enchevêtrant le ou les composants (15) d'une manière contrôlée. Une zone d'interaction (8) est disposée entre le premier et le second support (3, 4) dans laquelle la première section d'extrémité (6) et la seconde section d'extrémité (7) du ligament (2) se croisent dans une direction opposée longitudinalement appropriée pour être interconnectées l'une à l'autre.
PCT/EP2024/055752 2023-03-06 2024-03-05 Dispositif de tension de ligament WO2024184364A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CHCH000240/2023 2023-03-06
CH2402023 2023-03-06

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WO2024184364A1 true WO2024184364A1 (fr) 2024-09-12

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Citations (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4899761A (en) * 1988-03-31 1990-02-13 Brown Mark D Apparatus and method for measuring spinal instability
WO1994001057A1 (fr) 1992-07-07 1994-01-20 Gilles Voydeville Prothese intervertebrale permettant une stabilisation rotatoire et de flexion-extension
JPH0613808U (ja) * 1992-07-28 1994-02-22 株式会社神戸製鋼所 外科手術用ワイヤ緊張器
US6582433B2 (en) 2001-04-09 2003-06-24 St. Francis Medical Technologies, Inc. Spine fixation device and method
WO2006118259A1 (fr) 2005-05-02 2006-11-09 Alfresa Pharma Corporation Dispositif de fixation serrée pour câble de jointure d’os
WO2008070452A2 (fr) * 2006-11-21 2008-06-12 Cayenne Medical, Inc. Dispositifs et procédés de gestion et de tension de suture pour la reconstruction de tissu mou ou la fixation d'os à os
WO2009129269A2 (fr) * 2008-04-15 2009-10-22 Lonnie Paulos Ensemble chirurgical de mise sous tension et ses méthodes d'utilisation
WO2010141086A1 (fr) 2009-06-02 2010-12-09 Kinamed, Inc. Système de mise en tension d'un fil chirurgical
WO2011146739A1 (fr) * 2010-05-19 2011-11-24 Physcient, Inc. Procédés et dispositifs de diminution de traumatisme tissulaire pendant intervention chirurgicale
US20130184763A1 (en) * 2012-01-16 2013-07-18 K2M, Inc. Rod reducer, compressor, distractor system
CN204364111U (zh) 2014-11-28 2015-06-03 江苏双羊医疗器械有限公司 线缆收紧器
US20150320458A1 (en) * 2014-05-06 2015-11-12 Warsaw Orthopedic, Inc. Surgical instrument and method
WO2016116692A1 (fr) 2015-01-20 2016-07-28 Implanet Dispositif de fixation d'une bande plate sur une partie osseuse
US10271964B1 (en) * 2018-01-26 2019-04-30 Allosource System and methods of use for preparing and testing pre-sutured tendon constructs
EP3618743A1 (fr) 2017-05-04 2020-03-11 Cousin Biotech Ancillaire de mise en tension d'un element longiligne
WO2021071968A1 (fr) 2019-10-07 2021-04-15 Ortho Development Corporation Instrumentation de mise sous tension de câble d'attache et procédés associés
US11344337B2 (en) 2018-02-19 2022-05-31 Zimmer Biomet Spine, Inc. Systems for attenuation of increased spinal flexion loads post-fusion and associated methods

Patent Citations (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4899761A (en) * 1988-03-31 1990-02-13 Brown Mark D Apparatus and method for measuring spinal instability
WO1994001057A1 (fr) 1992-07-07 1994-01-20 Gilles Voydeville Prothese intervertebrale permettant une stabilisation rotatoire et de flexion-extension
JPH0613808U (ja) * 1992-07-28 1994-02-22 株式会社神戸製鋼所 外科手術用ワイヤ緊張器
US6582433B2 (en) 2001-04-09 2003-06-24 St. Francis Medical Technologies, Inc. Spine fixation device and method
WO2006118259A1 (fr) 2005-05-02 2006-11-09 Alfresa Pharma Corporation Dispositif de fixation serrée pour câble de jointure d’os
WO2008070452A2 (fr) * 2006-11-21 2008-06-12 Cayenne Medical, Inc. Dispositifs et procédés de gestion et de tension de suture pour la reconstruction de tissu mou ou la fixation d'os à os
WO2009129269A2 (fr) * 2008-04-15 2009-10-22 Lonnie Paulos Ensemble chirurgical de mise sous tension et ses méthodes d'utilisation
WO2010141086A1 (fr) 2009-06-02 2010-12-09 Kinamed, Inc. Système de mise en tension d'un fil chirurgical
WO2011146739A1 (fr) * 2010-05-19 2011-11-24 Physcient, Inc. Procédés et dispositifs de diminution de traumatisme tissulaire pendant intervention chirurgicale
US20130184763A1 (en) * 2012-01-16 2013-07-18 K2M, Inc. Rod reducer, compressor, distractor system
US20150320458A1 (en) * 2014-05-06 2015-11-12 Warsaw Orthopedic, Inc. Surgical instrument and method
CN204364111U (zh) 2014-11-28 2015-06-03 江苏双羊医疗器械有限公司 线缆收紧器
WO2016116692A1 (fr) 2015-01-20 2016-07-28 Implanet Dispositif de fixation d'une bande plate sur une partie osseuse
EP3618743A1 (fr) 2017-05-04 2020-03-11 Cousin Biotech Ancillaire de mise en tension d'un element longiligne
US10271964B1 (en) * 2018-01-26 2019-04-30 Allosource System and methods of use for preparing and testing pre-sutured tendon constructs
US11344337B2 (en) 2018-02-19 2022-05-31 Zimmer Biomet Spine, Inc. Systems for attenuation of increased spinal flexion loads post-fusion and associated methods
WO2021071968A1 (fr) 2019-10-07 2021-04-15 Ortho Development Corporation Instrumentation de mise sous tension de câble d'attache et procédés associés

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