Meniscus reattachment device

Abstract

In a meniscus reattachment device, with at least one needle and at least one implant, the implant is intended to have at least one extensible subsidiary surface.

Claims

1. A meniscus reattachment device (1), comprising at least one needle (2), comprising a shaft (8), and a front part (9), at least one implant (3), wherein the implant (3) has at least one extensible subsidiary surface (13, 14, 15, 16), a suture thread (7), and a tubular expansion ring (4) having an external diameter smaller than an internal diameter of the implant (3), an internal diameter larger than an external diameter of the shaft (8), and a bevel (17) facing the front part (9) of the needle (2), the expansion ring (4) being sized relative to the at least one extensible subsidiary surface (13, 14, 15, 16) for spreading open the at least one subsidiary surface (13, 14, 15, 16) of the implant (3) and fixing the suture thread (7) on the implant (3) when the expansion ring (4) is pressed into the implant (3). wherein the shaft (8) is smaller in diameter than the front part (9), and wherein the needle (2) has a longitudinal axis and a bore (11) parallel to the longitudinal axis, and a slit (12) extending through the front part (9) to the bore (11).

2. The device according to claim 1, further comprising a push rod (6), suitable for introducing the expansion ring (4) into the implant (3).

3. The device according to claim 1, wherein the needle (2) is plastically deformable by a force.

4. The device according to claim 1, further comprising a tubular shaft (5), suitable for receiving the needle (2).

5. The device according to claim 1, further comprising a flexible push rod, by means of which a force can be introduced along a curved needle by means of a pressure plate.

6. The device according to claim 1, wherein the at least one implant (3) and the expansion ring (4) fit over the shaft (8) in advance of insertion of the implant (3) to a meniscus.

7. A method of inserting at least one implant (3) for reattaching a meniscus (23), comprising the steps of: pressing a meniscus reattachment device (1), by a push rod (6), into a meniscus, the meniscus reattachment device (1) comprising: at least one plastically deformable needle (2) comprising a shaft (8) and a front part (9), wherein the shaft (8) is smaller in diameter than the front part (9), an implant (3) which has at least one extensible subsidiary surface (13, 14, 15, 16), a suture thread (7), a tubular expansion ring (4) having an external diameter smaller than an internal diameter of the implant (3), an internal diameter larger than an external diameter of the shaft (8), and a bevel (17) facing the front part of the needle (9) suitable for spreading open the at least one subsidiary surface (13, 14, 15, 16) of the implant (3) and fixing the suture thread (7) on the implant (3), wherein the needle (2) has a longitudinal axis and a bore (11) parallel to the longitudinal axis, and a slit (12) extending through the front part (9) to the bore (11); pressing the expansion ring (4) into the implant (3), whereby the expansion ring (4) forces the at least one extensible subsidiary surface (13, 14, 15, 16) to expand and hold the implant relative to the meniscus; and pulling the needle(2) proximally relative to the implant(3) whereby the needle (2) deforms and implant (3) moves distally over the needle (2) such that the needle (2) separates from the implant (3).

8. A meniscus reattachment device (1), comprising at least one plastically deformable needle (2), comprising a shaft (8), and a front part (9), a tubular implant (3), fitting over the shaft, having at least one extensible subsidiary surface (13, 14, 15, 16), a suture thread (7) passing through the tubular implant, a tubular expansion ring (4) having an external diameter smaller than an internal diameter of the implant (3), an internal diameter larger than an external diameter of the shaft (8), and a bevel (17) facing the front part (9) of the needle (2), the expansion ring (4) being sized relative to the at least one extensible subsidiary surface (13, 14, 15, 16) for spreading open the at least one subsidiary surface (13, 14, 15, 16) of the implant (3) and fixing the suture thread (7) on the implant (3) when the expansion ring (4) is pressed into the implant (3), wherein the needle (2) is deformable such that when the implant (3) is pushed toward the needle (2) in a direction of insertion, the needle (2) deforms and can be pulled out of the implant (3) counter to the direction of insertion and thereby separated from the implant (3), and wherein the shaft (8) is smaller in diameter than the front part (9), and wherein the needle (2) has a longitudinal axis and a bore (6) parallel to the longitudinal axis, and a slit (12) extending through the front part (9) to the bore (11).

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) The invention is briefly described below with reference to the appended figures, in which:

(2) FIG. 1 shows a schematic representation of a perspective exploded view of a device according to the invention;

(3) FIG. 2 shows a schematic sectional view of the meniscus reattachment device according to the invention in the assembled state;

(4) FIG. 3 shows a schematic representation of a side view of the meniscus reattachment device according to the invention in a further implantation step;

(5) FIG. 4 shows a schematic sectional representation of the side view of the meniscus reattachment device according to FIG. 3;

(6) FIG. 5 shows a schematic representation of a side view of the meniscus reattachment device in a further implantation step;

(7) FIG. 6 shows a schematic representation of a side view of a meniscus with a tear;

(8) FIG. 7 shows a schematic representation of a plan view of a meniscus according to FIG. 6, wherein the tear has been reattached using a device according to the invention as shown in FIGS. 1 to 5.

ILLUSTRATIVE EMBODIMENT

(9) FIG. 1 shows a device 1 according to the invention. The device 1 comprises a needle 2, an implant 3, an expansion ring 4, a tubular shaft 5, a push rod 6, and a suture thread 7.

(10) The needle 2 comprises a shaft 8 and a front part 9. The shaft 8 of the needle 2 has a smaller diameter than a front part 9 of the needle 2. The needle 2 thus forms a shoulder 10. Parallel to its longitudinal axis, the needle 2 has a bore 11. Moreover, in its front part 9, the needle 10 comprises a slit 12. The slit 12 extends through the front part 9 as far as the bore 11. Analogously, the shaft 8 of the needle 2 has a slit (not shown). The slit that is not shown extends from an end of the needle 2 to the front part 9 of the needle 2.

(11) The implant 3 is a tubular piece with an internal diameter larger than an external diameter of the shaft 8 of the needle 2. Moreover, the implant 3 has four extensible subsidiary surfaces 13, 14, 15 and 16.

(12) FIG. 2 shows the device 1 according to the invention in a state in which the device 1 is introduced into tissue, particularly a knee joint.

(13) As is shown in FIG. 2, the implant 3 is pushed onto the shaft 8 of the needle 2. The shoulder 10 of the needle 2 serves as a limit stop for the implant 3 and ensures that the implant 3 cannot slip over the front part 9 of the needle 2.

(14) The expansion ring 4 is likewise positioned on the shaft 8 of the needle 2. The expansion ring 4 is a tubular piece which, at a front end, has a bevel 17. An external diameter of the expansion ring 4 is smaller than an internal diameter of the implant 3. An internal diameter of the expansion ring 4 is larger than an external diameter of the shaft 8 of the needle 2.

(15) As can likewise be seen from FIG. 2, the tubular shaft 5 is also positioned on the shaft 8 of the needle 2. A front edge 18 of the tubular shaft 5 adjoins a rear edge 19 of the implant 3. The expansion ring 4 is received in the tubular shaft 5.

(16) Moreover, the pusher 6 is received at least partially on the shaft 8 of the needle 2. The pusher 6 is likewise a tubular piece, with an external diameter smaller than an internal diameter of the tubular shaft 5. The pusher 6 is likewise received at least partially in the tubular shaft 5. With a front edge 20, the pusher 6 bears on a rear edge 21 of the expansion ring 4.

(17) The function of the present invention is as follows:

(18) FIG. 6 shows a schematic side view of a meniscus 22 with a tear 23.

(19) For better clarity, a first implant in FIGS. 6 and 7 is designated by reference sign 3.1 and a second implant by reference sign 3.2. These implants are preferably identical and correspond to the structure of the described implant 3.

(20) For meniscus reattachment, two needles, each equipped with a respective implant 3.1, 3.2 and with a suture thread 7 and expansion ring, and connected via a common operating device (not shown), are introduced into the joint in a manner parallel to the tear 23.

(21) In addition to the common operating device, the two needles are also connected by a thread bridge (not shown).

(22) The two needles are preferably placed in a common. sheath. The common sheath serves to protect the needles and. the component parts and. to permit easier insertion of the device into the joint.

(23) In preferred illustrative embodiments, the tubular shaft is designed such that it can receive two needles, which are each equipped with an implant, a suture thread, an expansion ring and possibly also with a pusher.

(24) For the further description. of the use of the device 1 according to the invention, it is immaterial whether the needles are received together in one sheath or are each received in a. separate sheath.

(25) The first needle 2, equipped with the first implant 3.1, is pushed forward out of the tubular shaft 5 and, as can be seen from the course of the suture thread in FIG. 6, is introduced into the meniscus parallel to the tear 23. In the following, the introduction of an implant 3 is generally described as representative of the implantation of the implant 3.1.

(26) By actuation of the pusher 6, the expansion ring 4, as can be seen in FIGS. 3 and 4, is pushed under the implant 3 in such a way that the subsidiary faces 13, 14, 15 and 16 spread open. This has the advantage that the implant 3 is anchored in the cartilage or meniscal tissue. By means of the expansion ring 4 being driven into the implant 3, the suture thread 7 is at the same time fixed firmly in the implant 3. The tact that the subsidiary surfaces 13, 14, 15 and 16 spread open at the proximal end ensures that pulling-out of the implant becomes impossible. The suture thread 7 is advantageously fixed without a knot that could later rub on cartilage tissue or on the bone.

(27) In medical literature, instead of the term implant, the term anchor or suture anchor is often used for a component corresponding to the implant 3 of the present invention.

(28) The needle 2 is subsequently removed from the implant 3. For this purpose, as is shown in FIG. 5, the needle 2 is pulled rearward. in arrow direction P out of the implant 3 and out of the expansion ring 4 (not shown in FIG. 5). In doing this, the implant 3 serves as an abutment for the front part 9 of the needle 2. By means of the slit 12 and the bore 11, the front part 9 of the needle 2 is also designed such that it is plastically deformed when a certain force is reached, and it collapses in on itself in such a way that it can be removed through the implant 3 in arrow direction P.

(29) In preferred illustrative embodiments, at least the front part 9 of the needle 2 is made from a material which is sufficiently hard and strong enough to penetrate tissue, particularly cartilage tissue. However, the material of the front part 9 orate needle 2 is softer than a material of the implant 3, such that the implant 3 can serve as abutment.

(30) After the first needle 2 has been removed, the implant 3, with the suture thread 7 and. the expansion ring 4, remains in the meniscus 22.

(31) With the second needle, which is connected to the already inserted implant 3.1 via the suture thread 7 or the thread bridge, the second implant 3.2 is positioned analogously with respect to the tear 23.

(32) As is shown. in FIGS. 6 and 7, the suture thread 7 is secured with the implants 3.1 and 3.2 as a loop across the tear 23. The insertion of the second implant 3.2 takes place analogously to the fixing of the first implant 3.1. Before the expansion ring 4 is driven into the second implant 3.2 in order to fix the suture thread 7 and spread open the subsidiary surfaces 13, 14, 15 and 16, the tear 23 is closed by pulling on the suture thread 7, as is shown in FIG. 7. Finally, the second needle is removed from the implant 3.2 and the suture thread 7 is cut off.