Adjustable Button-Suture-Graft Construct for ACL Reconstruction
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Solution Overview
Problem
Current ACL reconstruction methods require precise calculation of graft length and may experience fluid extravasation and micromotion at the bone- graft interface, leading to tunnel widening and instability.
Innovation Solution
The use of a button/loop construct with an adjustable suture loop attached to fixation devices like wedges or plugs, allowing for adjustable tension and cortical fixation without pre-calculating the transosseous distance, and providing socket/tunnel compression to prevent fluid extravasation and micromotion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If precise calculation of graft length is performed, then accurate placement of graft within tunnels is achieved, but the surgical procedure becomes time-consuming and complex
Solution Approach 1:
The button/loop construct serves itself by automatically adjusting to the correct graft length through the adjustable loop mechanism, eliminating the need for the surgeon to perform complex pre-calculations and measurements of the transosseous distance
Solution Approach 2:
The loop length is made adjustable rather than fixed, allowing the construct to adapt to different graft lengths and anatomical variations without requiring precise pre-operative calculation, thereby simplifying the surgical procedure
2Strength
If interference screw fixation is used, then graft fixation within bone tunnels is achieved, but fluid extravasation and micromotion at the bone-graft interface occur leading to tunnel widening
Solution Approach 1:
The fixation system is divided into two functional components: the button/loop construct that provides adjustable tensioning and the wedge that provides compression and sealing. This segmentation allows each component to optimize its specific function without compromise
Solution Approach 2:
The wedge acts as an intermediary element between the button/loop construct and the bone tunnel, providing compression force that seals the interface and prevents fluid extravasation, while also minimizing micromotion
3Ease of operation
If adjustable button/loop construct is used, then the need for pre-calculating transosseous distance is eliminated, but device complexity increases
Solution Approach 1:
The button, adjustable loop, and wedge are merged into a single integrated construct that combines tensioning and compression functions, simplifying the surgical procedure while the internal adjustability manages the complexity
Data Source
AI summary
An adjustable button/loop device for securing biologic material in bone, such as for ACL reconstruction. The device has a pair of button/loop constructs, each including a flexible, adjustable loop integrated with a fixation device (for example, a wedge). Biologic material (for example, soft tissue, graft, ligament or tendon) is secured to the two fixation devices, and the construct is inserted into a pair of bone sockets/tunnels, such as into a tunnel in the tibia and a socket in the femur. The biologic material is secured within the bone by passing the buttons though respective bone sockets/tunnels, flipping and seating the buttons outside the bone, and then adjusting the lengths of the flexible adjustable loops passing through the buttons and the respective fixation devices, with the graft extending between the fixation devices thereby appropriately secured in the bone.