The way plastics anterior cruciate ligament of the knee joint

 

The invention relates to medicine, namely to traumatology and is used to repair a damaged cruciate ligaments of the knee joint. Entity: form two bone channel in the tibia: one at an angle of 60-70° relative to the tibial plateau, the second 40-50°. Next, form the two bone canal in one medial and the other lateral myselt of the femur. Then one implant is conducted through the channel formed in the tibia at an angle of 60-70°, and the channel in the medial myselt of the femur. At one end of the implant is fixed to the medial maselko of the femur to the tibia at an angle of flexion in the knee joint, 90°. A second implant is performed through the channel formed in the tibia at an angle of 40-50°, and through the channel in the lateral myselt of the femur. At one end of the implant is fixed to the outer maselko of the femur, and the second end to the tibia at an angle of flexion in the knee joint, equal to 45°. The method allows to eliminate pregnenalone and prednimustine instability of the knee joint. 2 Il.

When chronic injuries there is a combined instability of the knee joint, which is not effectively eliminated existing methods of arthroplasty of the knee joint ligaments. Therefore, the development of new and improvement of existing methods plastics ligaments of the knee joint remains an urgent task.

The known method plastics anterior cruciate ligament of the knee joint, including cutting, formation of channels in the femoral and tibial bones, holding the implant through the channels with subsequent fixation. In the outer myselt of the femur at the outer opening of the channel form a cortical anchor space in the sagittal plane, while the inner myselt tibia form a channel through the point of attachment of the ligament with two output holes on the front surface (Copyright certificate №1680113, IPC AND 61 IN 17/56, BI No. 36, 1991)

However, the effectiveness of treatment in this way is not high enough, since the method does not resolve pregnenalone and prednimustine instability of the knee joint.

Closest to the present invention is a method plastics cruciate ligament of the knee joint, my bones and the formation of two bone channels in medial myselt and channel in the outer myselt femur, conduction through these channels implants in the form of a harness, locking them all. One of the implants performed from front to back through the canal of the tibia, its branch at the exit of the channel and then hold the branched ends from the inside outwards through the appropriate channels of the medial condyle of the femur, and a second implant is performed from front to back through the second channel of the tibia and from the inside outwards through the outer condyle of the femur (RF Patent No. 2116054, AND 61 IN 17/56, BI No. 21, 1998).

However, this method also does not resolve pregnenalone and prednimustine instability of the knee joint. And, in this regard, the method is not sufficiently high efficiency of treatment.

The aim of the invention is to increase the effectiveness of treatment.

This objective is achieved in that form two bone channel in the tibia: one at an angle of 60-70° relative to the tibial plateau, the second 40-50°. Next, form the two bone canal in one medial and the other lateral myselt of the femur. Then carried out through the channels implants as follows: first, the implant is performed through the channel formed in the tibia at an angle hidialer maselko femur, and the other end to the tibia at an angle of flexion in the knee joint, 90°. A second implant is performed through the channel formed in the tibia at an angle of 40-50°, and through the channel formed in the lateral myselt of the femur. At one end of the implant is fixed to the outer maselko of the femur, and the other end to the tibia at an angle of flexion in the knee joint, equal to 45°.

Comparative analysis of the prototype showed that the proposed method differs from the known fact that one channel in the tibia form an angle of 60-70°, and another 40-50° with respect to its plateau, the first implant is performed through the channel formed at an angle of 60-70° in the tibia, and the channel in the medial myselt femur, with one end of the implant is fixed to the medial maselko of the femur to the tibia at an angle of flexion in the knee joint, 90°, and the second implant is performed through the channel formed at an angle of 40-50° in the tibia, and the channel in the lateral myselt femur, with one end of the implant is fixed to the lateral maselko of the femur to the tibia at an angle is their invention of “novelty.”

The analysis of patent and scientific literature showed that the proposed solution differs not only from the prototype, but also on other technical solutions in this and related fields. So, the author has not found ways of surgical treatment of anterior cruciate ligament of the knee joint, which would include the proposed techniques. Namely, the proposed modes allow you to achieve your goal of increasing the effectiveness of treatment. The proposed method allows to approach the physiological anatomy of the cruciate ligaments of the knee joint and to eliminate pregnenalone and prednimustine instability of the knee joint. The proposed method allows for chronic injuries of the anterior cruciate ligament of the knee joint simultaneously with the plastic of the anterior cruciate ligament to stabilize the rear and lateral ligament of the knee joint, which increases the effectiveness of treatment.

The proposed method can be used in the departments of traumatology.

Thus, this solution meets the criteria of “inventive step” and “industrial applicability”.

The method is as on the channel in the tibia. The first channel is formed at an angle of 60-70° relative to the tibial plateau, the second at an angle of 40-50°. Then form the channels in the medial condyles of the femur: the first in the medial, the second lateral. Through the formed channels hold the implants. The implant serves as a strip of synthetic material. One implant is conducted through the channel formed in the tibia at an angle of 60-70° with respect to its plateau, and through the channel in the medial myselt of the femur. The implant is performed from front to back and top to bottom through the canal of the tibia and from the inside outwards and upwards through the channel formed in the inner myselt of the femur. One end of the implant is fixed by screws and/or brackets to the medial maselko of the femur, and the other end is fixed at the angle of flexion in the knee joint, 90° to the tibia. A second implant is performed through the channel formed in the tibia at an angle of 40-50° with respect to its plateau, and through the channel in the lateral myselt of the femur. The implant is performed from front to back and top to bottom through the canal of the tibia and from the inside to the outside and from the bottom up through the channel in the lateral myselt of the femur. Fixation odnorazoaya angle of flexion in the knee joint is equal to 45° to the tibia.

In Fig.1 presents a diagram of the location of the implant in the knee joint in the frontal plane; Fig.2 is a diagram of the location of the implant in the knee joint in sagitally plane.

In the tibia 1 (see Fig.1, 2), formed two bone channel: one channel 2 is at an angle of 60-70°, the other channel 3 is at an angle of 40-50° relative to the tibial plateau. In the femur 4 is also formed two channels: channel 5 - in medial myselt and channel 6 in the lateral myselt.

Example 1. B-th Century, 29 years.

Diagnosis: anteromedial instability, damage to the medial meniscus of the right knee.

The injury occurred 3 years ago.

Performed arthroscopic diagnosis. Identified damage to the medial meniscus (longitudinal, transchondral gap offset Dandy IV), absence of the anterior cruciate ligament. Conducted partial resection of the medial meniscus. Drill 5 mm diameter formed two channels in the tibia. First channel formed at an angle of 60° relative to the tibial plateau, the second at an angle of 40°. Then form the channels in the medial condyles of the femur: the first in the medial, the second lateral. Through: open the first in the tibia at an angle of 60° on its plateau, and through the channel formed in the medial myselt of the femur. One end of the implant is fixed by screws to the medial maselko of the femur, and the second end of the implant is fixed at an angle of flexion in the knee joint, 90° to the tibia. A second implant is performed through the channel formed in the tibia at an angle of 40° with respect to its plateau, and through the channel formed in the lateral myselt of the femur. Fixing one end of the implant to produce lateral maselko femur with screws and the other end is at an angle of flexion in the knee joint, equal to 45° to the tibia.

The result of the treatment have been traced for 3 years. Pain and swelling were observed. The function of the knee joint fully restored. Atrophy of the muscles of the limbs not.

Example 2. B-Oh So, 38 years old.

Diagnosis: prednisonemedicine instability (anteromedial + + + rear +), damage to both meniscus of the left knee.

Injury received 8 years ago, it was 6 outpatient cases.

Performed arthroscopic diagnosis. Identified damage to the posterior horns of both menisci, the gap (lack 2/3) anterior cruciate connections>is raveena partial resection of both menisci. Drill 5 mm diameter to form two channels in the tibia. The first channel is formed at an angle of 70° relative to the tibial plateau, the second angle of 50°. Then form the channels in the medial condyles of the femur: the first in the medial, the second lateral. Through the formed channels conduct polyester implants. One implant is carried out through the first channel formed in the tibia at an angle of 70° with respect to its plateau, and through the channel formed in the medial myselt of the femur. One end of the implant is fixed to the bracket on the medial maselko of the femur, and fixing the second end of the produce at an angle of flexion in the knee joint, 90° to the tibia. Thus, in addition to the plastic of the anterior cruciate ligaments, stabilize the posterior cruciate ligament of the knee joint.

A second implant is performed through the channel formed in the tibia angle of 50° with respect to its plateau, and through the channel formed in the lateral myselt of the femur. Fixing one end of the implant to produce lateral maselko thigh straps, and the second - under the angular-x years. The patient has no complaints. Pain and swelling were observed. The range of motion was observed in full. The function of the knee joint fully restored. Symptoms of instability of the knee joint no.

The proposed method of treatment was used in 27 patients with ruptures of the anterior cruciate ligament of the knee joint. All patients noted the positive effect of the recovery movement in the joint in full, no pregnenalone, prednimustine and posterior instability of the knee joint.

In the process of dynamic observations within 2-3 years shows the preservation of the treatment effect.

Claims

The way plastics anterior cruciate ligament of the knee joint, including the formation of two bone channels in the tibia and two channels in the thigh, one in the medial myselt, the other in the lateral, the subsequent conduct of the through channels formed implants, one implant is performed from front to back through the canal of the tibia and forth from the inside outwards through the channel in the medial myselt of the femur, and the other implant is performed from front to back through the second channel of the tibia is, characterized in that one channel in the tibia form an angle of 60-70°, and another 40-50° with respect to its plateau, the first implant is performed through the channel formed in the tibia at an angle of 60-70° and the canal in the medial myselt femur, with one end of the implant is fixed to the medial maselko of the femur to the tibia at an angle of flexion in the knee joint, 90°, and the second implant is performed through the channel, formed in the tibia at an angle of 40-50° and the channel in the lateral myselt femur, with one end of the implant is fixed to the lateral maselko of the femur to the tibia at an angle of flexion in the knee joint, equal to 45°.



 

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