CLAMPING ELEMENT AND SETTING ASSEMBLY

Abstract

A setting assembly for a clamped fixation of a tissue strand, such as a tendon or a band in particular, to a securing recess, which is recessed into a bone, has a clamping element which has a clamping section that tapers along a central axis of the clamping element towards a first end, a recess that is provided on a second end facing away from the first end for passing through the tissue strand, and a tool receiving area that is recessed onto the first end and has a first contact for applying a force acting in a pushing direction and a second contact for applying a force acting in a pulling direction opposite the pushing direction. The setting assembly additionally has an applicator which has an insertion end for releasably connecting to the tool receiving area, the insertion end having a first mating contact which can be placed against the first contact and a second mating contact which can be placed against the second contact means. The tool receiving area has first and second rotation locks, and the insertion end of the applicator has a rotating device which can be placed against the first and second rotation locks in a first rotational direction and a second rotational direction opposite the first rotational direction in order to transmit first and second torques.

Claims

1. A setting assembly for the clamped fixation of a tissue strand to a fixing recess let into a bone, comprising: a clamping element having a clamping portion tapering along a central axis of the clamping element towards a first end, a recess provided at a second end remote from the first end for the passage of the tissue strand, and a tool receptacle embedded at the first end which has and having a first contact configured to apply a force acting in a pushing direction and a second contact configured to apply a force acting in a pulling direction in the opposite direction to the pushing direction; and an applicator having an insertion end for releasable connection to the tool receptacle, the applicator having a first mating contact configured to be applied to the first contact and a second mating contact configured to be applied to the second contact, wherein the tool receptacle has a first rotation lock and a second rotation lock, and the insertion end of the applicator has a rotating device that can be applied in a first direction of rotation and in a second direction of rotation, opposite to the first direction of rotation, for transmitting first and second torques to the first and second rotation locks.

2. The setting assembly according to claim 1, wherein in a connection position both of the first and second contacts can be applied simultaneously to the first and second mating contacts, and the rotating device can be applied simultaneously to the first and second rotation locks.

3. The setting assembly according to claim 2, wherein in the connected position a form closure is formed both between the first and second contacts and first and second mating contacts, and between the rotating device and first and second rotation locks.

4. The setting assembly according to claim 1, wherein the first mating contact is formed by a distal shank end of an applicator shank and the second mating contact is formed by a latch, the latch being displaceable between a release position and a latching position and, in the latching position, projects beyond a peripheral surface of the applicator shank for forming a frictional or positive engagement with an undercut recess of the tool receptacle.

5. The setting assembly according to claim 4, wherein the latch comprises a spring washer.

6. The setting assembly according to claim 4, wherein the latch comprises latching bodies, the latching bodies being displaceable and fixable in the latching position.

7. The setting assembly as claimed in claim 6, wherein the applicator has an adjusting pin displaceable within the applicator shaft the adjusting pin blocking radial inward displacement of the latching bodies in a latching position and releases the latching bodies in a release position.

8. The setting assembly according to claim 1, wherein the first and second locks are formed by a polygonal receptacle acting in the first and second directions of rotation and the rotating device is formed by a polygonal profile provided at a distal end of the applicator shaft.

9. The setting assembly according to claim 1, wherein the rotating device comprises a bayonet cam engageable with a bayonet receiver of the tool receiver.

10. An applicator assembly according to claim 9, wherein the bayonet receptacle comprises a first bayonet receptacle and a second bayonet receptacle arranged offset thereto, and a first bayonet cam receivable in the first bayonet receptacle and a second bayonet cam receivable in the second bayonet receptacle are provided on the applicator, which is rotatably held with respect to the first bayonet cam.

11. The applicator assembly of claim 10, the first bayonet cam is connected to a first handle portion via a first partial shaft and the second bayonet cam is connected to a second handle portion of the applicator via a second partial shaft.

12. A clamping member for use in the setting assembly according to claim 1, wherein two lateral abutment surfaces are provided on opposite sides of the clamping portion and extending between the recess and the first end.

13. The clamping member according to claim 12, wherein the recess is formed in a closed eyelet shape.

14. The clamping member according to claim 12, wherein the recess is U-shaped and open towards the second end.

15. The clamping member according to claim 12, wherein a guide groove is let into at least one of the lateral contact surfaces in the direction of the recess.

16. The clamping member according to claim 15, wherein the guide groove comprises a groove bottom profile with different pitches.

17. The clamping member according to claim 16, wherein the groove bottom profile forms a convex contour in the clamping section.

18. The clamping member according to claim 15, wherein the guide groove opens into the recess via a rounded deflection region.

19. The clamping member according to claim 12, wherein an additional thread guide for a guide thread is let in at the recess.

20. The clamping member according to claim 19, wherein the additional thread guide comprises an exit gap.

21. The clamping member according to claim 19, wherein the additional thread guide is designed as a double thread guide for two guide threads guided at a distance from one another.

22. The clamping member according to claim 12, wherein roughenings are formed on the lateral contact surfaces for increased friction with respect to an abutting tissue strand.

23. The clamping member according to claim 22, wherein the roughenings are formed by tooth structures, teeth of the tooth structures being at least partially inclined in the direction of a threading direction on both lateral contact surfaces.

24. The clamping member according to claim 23, wherein the roughenings extend with respect to the central axis at a level of a convex portion of the groove bottom profile.

25. An applicator for use in the setting assembly according to claim 1.

Description

[0033] An exemplary embodiment of the invention is shown in the Figures. It shows:

[0034] FIG. 1 a partial sectional view of a setting assembly during a setting operation,

[0035] FIG. 2 a perspective view of a clamping element of the setting assembly according to FIG. 1,

[0036] FIG. 3 a perspective view of an alternative embodiment of the clamping element with a rectangular tool receptacle,

[0037] FIG. 4 a longitudinal section through the clamping element according to FIG. 3,

[0038] FIG. 5 a top view of a first end of the clamping element according to FIG. 3,

[0039] FIG. 6 a longitudinal section through the clamping element according to FIG. 3 in the attached state on an adapted applicator,

[0040] FIG. 7 a perspective view of a further alternative embodiment of the clamping element with a hexagonal tool receptacle,

[0041] FIG. 8 a longitudinal section through the clamping element according to FIG. 7,

[0042] FIG. 9 a top view of a first end of the clamping element according to FIG. 7,

[0043] FIG. 10 a longitudinal section through the clamping element according to FIG. 7 in the attached state on an adapted applicator,

[0044] FIG. 11 a perspective view of a further alternative embodiment of the clamping element with a bayonet mount,

[0045] FIG. 12 a longitudinal section through the clamping element according to FIG. 11,

[0046] FIG. 13 is a top view of a first end of the clamping member shown in FIG. 11,

[0047] FIG. 14 a longitudinal section through the clamping element according to FIG. 11 in the attached state on an applicator,

[0048] FIG. 15 a longitudinal section through the clamping element according to FIG. 11 in the attached state on an applicator, rotated by 90° compared to FIG. 14,

[0049] FIG. 16 a perspective view of the applicator shown in FIGS. 14 and 15 with the clamping element removed,

[0050] FIG. 17 a perspective view of a further alternative embodiment of the clamping element with an open recess, and

[0051] FIG. 18 a perspective view of a further alternative embodiment of the clamping element with a double thread guide.

[0052] FIG. 1 shows a setting assembly 2 with a clamping element 4 for the clamped fixation of a tissue strand 6, such as a tendon, a tendon substitute, or a band, such as a cruciate band substitute, to a securing recess 10 let into a bone 8. For this purpose, the securing recess 10 is formed by a bore which is additionally undercut in such a way that it tapers, at least in sections, in the direction of an entry opening 12.

[0053] In addition, the setting assembly 2 comprises an applicator 14 having an applicator shaft 16 to the distal end 18 of which the clamping element 4 can be releasably attached. The applicator 14 serves to insert the clamping element 4 into the securing recess 10 and to bring it into a suitable position there or to hold it in this position. For this purpose, a guide thread 22 already threaded in advance at a recess 20 of the clamping element 4 is carried along, which is connected to the tissue strand 6 to be fastened. By pulling on the guide thread 22, the tissue strand 6 is then guided within the securing recess 10 through the recess 20 and deflected at the latter, as shown by dash-dotted lines. Once one end 24 of the tissue strand 6 has re-emerged from the securing recess 10 of the bone 8, the tissue strand 6 deflected at the clamping element 4 can be clamped in the securing recess 10 by appropriately displacing the clamping element 4 in the direction of the entry opening 12 by means of the applicator 14. Should the deflected tissue strand 6 assume a clamping position which does not correspond to the desired position, the clamping element 4 can be released from the clamping position again by applying thrust by means of the applicator 14 and displaced into the securing recess 10 in order to subsequently clamp the deflected tissue strand 6 in a corrected position in the securing recess 10. During this entire process, the tissue strand 6 can thereby be subjected to a tensile force K via the guide thread 22 in order to fix it to the securing recess 10 with a desired pretension. In this clamping position and with the pretension applied, the tissue strand can then grow together with the bone 8, as in particular in the region of the cortex.

[0054] As can be seen from FIG. 2, the clamping element 4 has a clamping section 26 which tapers along a central axis A towards a first end 28 of the clamping element 4. The recess 20 at which the tissue strand 6 can be received and deflected is arranged at a second end 30 of the clamping element 4 facing away from the first end 28, so that after threading the tissue strand 6 extends along two opposite sides of the clamping section 26 at which the clamping element 4 forms lateral abutment surfaces 32 extending between the recess 20 and the first end 28.

[0055] As can be seen from FIG. 2, roughenings 34 in the form of tooth structures can be formed on the lateral contact surfaces 32, which serve to increase the friction with respect to an adjacent tissue strand 6. Preferably, the roughenings 34 are inclined in the direction of a threading direction E of the tissue strand 6, in order to be able to counteract a backward displacement of the tissue strand 6.

[0056] As can further be seen from the embodiment of the clamping element 4 according to FIGS. 3 to 5, the clamping element 4 has a tool receptacle 36 at the first end 28, via which the clamping element 4 can be releasably attached to the distal end 18 of the applicator 14. As can be seen from FIG. 4, this forms first contact means 38 in the form of a receiving base via which the clamping element 4 can be subjected to a pushing force in a pushing direction S by means of the applicator 14 in order to position the clamping element 4 within the securing recess 10.

[0057] As can also be seen from FIG. 4, the tool receptacle 36 also has second contact means 40 which are formed by at least one locating region 44 which is formed, by way of example, in the form of a rear gripping recess let into the side wall 42. In this case, the second contact means 40 serve to produce a positive-locking, quasi-positive or purely non-positive connection with the applicator 14, which connection is effective in a tensile direction opposite to the direction of thrust S, in order to be able to apply a tensile force Z to the clamping element 4.

[0058] In this embodiment according to FIG. 5, the tool receptacle 36 is formed by a polygonal holder with an exemplary rectangular cross-section. The rectangularly circumferential side wall 42 of the polygonal receptacle thus forms first rotation-locking means 46 in the form of rotation stops, by means of which a transmission of first torques M1 from the applicator 14, effective around the center axis A in a first direction of rotation D1, can be effected, and second rotation-locking means 48 in the form of rotation stops, by means of which a transmission of second torques M2 from the applicator 14, effective around the center axis A in a second direction of rotation D2, can be effected.

[0059] As can be seen from the setting assembly 2 according to FIG. 6 with the clamping element 4 according to FIGS. 3 to 5, the applicator shaft 16 forms an insertion end 52 at the distal end 18, to which the clamping element 4 can be attached. In this regard, an end face 53 of the insertion end 52 forms first mating contact means 50 which can be applied to the first contact means 38 when the clamping element 4 is attached, in order to enable a force transmission in the thrust direction S. In addition, second counter-contact means 54 are provided at the insertion end 52, which cooperate with the second contact means 40 in order to enable a force transmission in the pulling direction Z.

[0060] The insertion end 52 itself and/or the second counter-contact means 54 arranged on it also act as rotating means 55 of the applicator 14 which, in the connection position shown in FIG. 6, are simultaneously in direct contact with both rotation-locking means 46, 48 of the clamping element 4 and via which the torques M1, M2 can thus be generated.

[0061] The second counter-contact means 54 may thereby be formed by latching means which are displaced radially outwardly so as to project beyond a lateral surface 56 of the applicator shaft 16 and thereby, in the fitted state of the clamping element 4, engage in the second contact means 40 thereof or cooperate with the locating region 44. As exemplarily shown in FIG. 6, the counter-contact means 54 can be formed, for example, by radially displaceable latching bodies 58 which project beyond the lateral surface 56 in a latching position.

[0062] In this regard, as shown, the applicator 14 may include an adjusting pin 60 displaceable within the applicator shaft 16. In the position shown, this adjusting pin 60 blocks a radially inward displacement of the latching bodies 58. In this way, a positive engagement of the latching bodies 58 on the second contact means 40 of the clamping element 4 can be ensured. By actuation of, for example, a button-shaped handle 62 on an applicator handle 64, the adjusting pin 60 can be displaced distally from the illustrated latching position, counter to a spring F, into a release position. In this position, the latching bodies 58 can be displaced radially inwardly into pin recesses 61 of the adjusting pin 60 and thus into the lateral surface 56 (not shown). In this release position, the clamping body 4 can thus be released from the insertion end 52 of the applicator 14.

[0063] FIGS. 7 to 9 show another alternative embodiment of the clamping element 4, which has a tool receptacle 36 at the first end 28, in which the second contact means 40 are formed by a circumferential receiving groove 66.

[0064] Also, in this embodiment according to FIGS. 7 to 9, the tool receptacle 36, as can be seen in particular from FIG. 9, is formed by a polygonal holder which, however, has an exemplary hexagonal cross-section. Here, the hexagonal circumferential side wall 42 of the polygonal receptacle forms the first rotation-locking means 46 in the form of rotation stops, by means of which the first torques M1 can be transmitted in the first direction of rotation D1, and the second rotation-locking means 48 in the form of rotation stops, by means of which the second torques M2 can be transmitted in the second direction of rotation D2. For transmitting the torques M1, M2 from the applicator 14, its insertion end 52 has a polygonal profile adapted to the side wall 42. In the connection position shown in FIG. 10, the insertion end 52 thus forms the rotating means 55 bearing against the rotation-locking means 46, 48 in both directions of rotation D1, D2.

[0065] Moreover, as can be seen from the setting assembly according to FIG. 10 with the clamping element 4 according to FIGS. 7 to 9, the end face 53 of the insertion end 52 also forms the first mating contact means 50 in this embodiment, which can be applied to the first contact means 38 when the clamping element 4 is inserted, in order to allow force transmission in the direction of thrust S. The second counter-contact means 54, on the other hand, are formed by a spring washer 68 which is held on the lateral surface 56 and interacts with the second contact means 40 and the receiving groove 66, respectively, in order to permit a force transmission in the pulling direction Z in a force-fitting manner.

[0066] FIGS. 11 to 13 show a further alternative embodiment of the clamping element 4, which has a tool receptacle 36 at the first end 28, in which the first and second contact means 38, 40 are formed by a bayonet receptacle 70 for forming a bayonet connection with the applicator 14. In this regard, the bayonet receptacle 70 comprises a first bayonet receptacle 70A and a second bayonet receptacle 70B offset therefrom along the central axis A.

[0067] The first bayonet receptacle 70A thereby forms the first anti-rotating means 46 and the second rotation-locking means 48 in the form of rotation stops, via which the first torques M1 can be transmitted by the applicator 14 in the first direction of rotation D1 and the second torques M2 can be transmitted by the applicator 14 in the second direction of rotation D2. The second bayonet receptacle 70B forms the second contact means 40, for the application of force by the applicator 14, effective in the pulling direction Z.

[0068] As can be seen from the setting assembly according to FIG. 14 with the clamping element 4 according to FIGS. 11 to 13, the first mating contact means 50 are formed by a first bayonet cam 72A arranged at the distal end 18 of the applicator shaft 16 and cooperating with the first contact means 38 and the first bayonet receptacle 70A, respectively, in order to allow a force transmission in the pushing direction S by force.

[0069] In this respect, as can be seen from FIG. 15, the first bayonet receptacle 70A is slot-shaped and is adapted in shape and size to the bayonet cam 72A in such a way that, in the illustrated connecting position of the applicator 14 with the clamping element 4, it forms the first and second rotation-locking means 46, 48. In the connected position, the first bayonet cam 72A bears against these simultaneously in both directions of rotation D1 and D2 and in this way forms the rotating means 55. As a result of the simultaneous direct bearing, the first and second torques M1, M2 can thereby be transmitted directly from the applicator 14 to the clamping element 4 without any idle travel, even when the directions of rotation are changed.

[0070] In particular, as can be seen from FIG. 16, the applicator 14 shown in FIGS. 14 and 15 has a two-part applicator shaft 16. An outer first partial shaft 74A, which is connected to a first handle part 76A, thereby forms the lateral surface 56 with the first bayonet cam 72A projecting therefrom. The second bayonet cam 72B, on the other hand, is provided on a second partial shaft 74B arranged inside the first partial shaft 74A, which second partial shaft 74B is connected to a second grip part 76B and can be rotated relative to the first partial shaft 74B or its first bayonet cam 72A.

[0071] As a result, the second bayonet cam 72B can initially be inserted into the tool receptacle 36 of the clamping member 4 in alignment with the first bayonet cam 72A. Once the first bayonet cam 72A is received within the first bayonet receptacle 70A, the second bayonet cam 72B can be rotated relative thereto within the second bayonet receptacle 72B, such as by 90°, to thereby apply it in the direction of pull Z against the second contact means 40 formed by the second bayonet receptacle 70B, as can be seen in FIG. 15. In order to be able to fix an assumed angular position of the two bayonet cams 72A, 72B in relation to one another, they can be fixed to one another by means of latching or locking means provided, for example, between the handle parts 76A, 76B (not shown).

[0072] Due to the two bayonet cams 72A, 72B which can be rotated relative to each other, in the connected position with the clamping element 4 a direct transmission of force is thus possible both in the pushing direction S and the pulling direction Z and a transmission of the first and second torque M1, M2, respectively, is possible in both directions of rotation D1 and D2, without an idle travel without transmission of force or torque occurring during a change of direction or direction of rotation. In order to separate the applicator 14 from the clamping element 14, the two bayonet cams 72A, 72B must be rotated back into a common alignment in order to be able to be removed again from the tool receptacle 36.

[0073] In all embodiments according to FIGS. 1 to 15, the clamping element 4 has a recess 20 which is formed in the shape of a closed eyelet. In addition, the recess 20 has an elliptical shape in order to be able to thread the tissue strand 6 to be fixed more easily.

[0074] Alternatively, the recess 20 according to the embodiments shown in FIGS. 17 and 18 may be U-shaped and thereby open towards the second end 30 to allow even easier threading and deflection of the tissue strand 6 to be fixed.

[0075] In all embodiments, the clamping element 4 may further comprise guide grooves 80 recessed into the two lateral contact surfaces 32 and thereby directed towards the recess 20. When threading and deflecting the tissue strand 6, better centering relative to the recess 20 can be achieved by these guide grooves 80.

[0076] As can be seen in particular from FIGS. 4, 8 and 12, a groove bottom profile 82 of these guide grooves 80 thereby has different pitches in order to be able to adapt different sections of the clamping element 4 to their respective function during deflection and in particular during clamping of the tissue strand 6 deflected at the clamping element 4. Thus, the groove bottom profile 82 has a convex contour at the level of the clamping section 26 and the roughening 34 preferably formed therein (according to FIG. 2), in order to generate the greatest clamping forces in this region, at least in tendency, and thereby to achieve maximum stability of the clamped fixation.

[0077] In addition, in all embodiments of the clamping element 4, the guide groove 80 opens into the respective recess 20 via a rounded deflection region 84 in order to avoid, as far as possible, jamming of the tissue strand 6 when it is threaded into the recess.

[0078] As shown by way of example for the embodiment of the clamping element 4 according to FIG. 17, a thread guide 86 can additionally be let into the recess 20, in which the guide thread 22 is held and guided in particular during the insertion of the clamping element 4 into the securing recess 10. In this respect, the thread guide 86 has an exit gap 88 which has a gap width relative to the guide thread 22 which is narrow enough to accommodate the latter in a manner preventing loss, or to fix the clamping element 4 to the guide thread 22 before and during insertion into the securing recess 25. Moreover, the guide thread 22 can exit the thread guide 86 via this exit gap 88 as soon as the end 24 of the tissue strand 6 passes the recess 20.

[0079] In order to be able to guide the end 24 of the tissue strand 6 during deflection in a particularly stable manner and with a larger deflection radius in relation to the clamping element 4, a double thread guide 86 can also be provided on the recess 20, as shown in FIG. 18. This enables the use of two spaced-apart guide threads 22, both of which are attached to the end 24 of the tissue strand 6. These guide the tissue strand 6 into the securing recess 10, around the clamping element 4, through the recess 20 and back out of the entry opening 12. When tension is applied via the at least one guide thread 22, the tissue strand 6 can then be clamped in the securing recess 10 with the aid of the clamping element 4 guided on the applicator 14, so that it can later fuse with the bone 8 in the fixed position and, if necessary, under tension.

[0080] It is noted that all the elements and features of the various embodiments of the article according to the invention described above are interchangeable or combinable with one another, provided that an interchange or combination thereof is not precluded for technical reasons.