ACL Graft Fixation Loop and Sleeve System
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Solution Overview
Problem
Achieving adequate fixation of ACL grafts through either intra-cortical or extra-cortical methods while maintaining a minimal extra-cortical profile remains a challenge in ACL repair surgery, necessitating innovative solutions for secure graft retention and tension maintenance.
Innovation Solution
The development of a system comprising a cortical loop fixation device and a sleeve-screw construct that secures the graft within a bone tunnel, utilizing a loop fixation device with flanges and a retention portion to engage the graft outside the tunnel, and a sleeve with anti-rotation features to stabilize the screw, ensuring secure fixation without the need for toggling or external sutures.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If traditional reconstruction methods with longer tunnels are used, then graft fixation strength is improved, but tunnel length increases and surgical complexity increases
Solution Approach 1:
The fixation system is divided into two independent components: an intra-cortical sleeve-screw construct for immediate mechanical fixation and an extra-cortical loop fixation device for additional stabilization. This segmentation allows each component to be optimized for its specific function while working together to achieve overall fixation strength without requiring extended tunnel lengths
Solution Approach 2:
The invention transitions from purely intra-cortical fixation to a dual-plane system by adding extra-cortical loop fixation. This dimensional addition provides a new fixation pathway outside the bone tunnel, enabling secure graft retention without extending the tunnel length, thereby resolving the contradiction between fixation strength and tunnel length
2Reliability
If extra-cortical fixation devices are used, then graft retention is improved, but extra-cortical profile increases
Solution Approach 1:
The extra-cortical fixation device utilizes a thin, flexible loop configuration that can be positioned outside the bone tunnel to provide secure graft retention. The loop's slender profile minimizes the extra-cortical footprint while maintaining sufficient mechanical engagement with the graft, resolving the contradiction between reliable retention and minimal profile
3Device complexity
If intra-cortical fixation alone is used, then surgical simplicity is maintained, but fixation adequacy is insufficient for shortened tunnels
Solution Approach 1:
The invention merges intra-cortical and extra-cortical fixation methods into a unified system. The intra-cortical sleeve-screw construct provides immediate mechanical stability within the tunnel, while the extra-cortical loop adds supplemental retention. This combination ensures fixation adequacy for shortened tunnels while maintaining relative surgical simplicity through standardized implantation procedures
Data Source
AI summary
A system for graft fixation including ACL graft reconstruction and fixation is presented. The system may comprise a loop fixation device for retaining a tissue graft. The loop fixation device may comprise a graft retention portion and a cortical fixation portion to allow the loop fixation device to rest on the cortical portion of a bone. A tissue graft may pass through a bone tunnel and engage the loop fixation device preventing withdraw of the tissue graft back through the bone tunnel. The system may also include graft fixation within a bone tunnel using a sleeve, or tube construct, with a fixation member, or screw, to engage a tissue graft within the sleeve.