Adjustable Suture Button Construct for ACL Graft Fixation
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Solution Overview
Problem
Existing ACL reconstruction methods require precise calculation of graft length and may suffer from graft loosening and tunnel widening due to micromotion, necessitating complex fixation techniques.
Innovation Solution
A button/loop construct with a flexible, adjustable loop that allows for one-directional adjustment and locking, eliminating the need for pre-calculation of graft length, and incorporates a graft supporting device to minimize micromotion and fluid extravasation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If interference screw fixation is used for ACL reconstruction, then graft fixation is achieved, but precise calculation of graft length is required and complex fixation techniques are needed
Solution Approach 1:
The button construct incorporates an adjustable suture loop that can be dynamically modified during surgery. The loop length can be adjusted by cutting the suture material to match the actual graft length, eliminating the need for pre-calculation and reducing the complexity of the fixation technique while maintaining reliable graft fixation.
Solution Approach 2:
The invention changes the parameter of suture loop length from fixed to adjustable. By allowing the suture loop length to be modified based on the actual graft length during surgery, the system achieves reliable fixation without requiring complex preoperative calculations or multiple sized buttons.
2Reliability
If fixed loop length buttons are used, then graft fixation is provided, but graft loosening and tunnel widening occur due to micromotion
Solution Approach 1:
The adjustable suture loop allows dynamic adaptation to the actual graft length and tension requirements. This dynamic adjustment capability enables the button construct to maintain optimal fixation while preventing excessive micromotion that would cause tunnel widening and graft loosening, thereby improving tunnel stability.
Solution Approach 2:
The system provides feedback through the adjustable suture loop that can be modified based on intraoperative findings. This feedback mechanism allows real-time optimization of the fixation to prevent graft loosening and tunnel widening, enhancing overall stability.
3Measurement precision
If pre-calculation of graft length is performed, then accurate graft placement is achieved, but surgical time and complexity increase
Solution Approach 1:
The adjustable suture loop eliminates the need for pre-calculation of graft length. Instead of requiring precise measurements and calculations before surgery, the loop can be adjusted during the procedure to match the actual graft length, significantly reducing surgical time while maintaining accurate graft placement through direct measurement and adjustment.
Solution Approach 2:
The button construct is designed with a pre-adjustable suture loop that can be quickly modified during surgery without requiring complex preoperative planning or measurement. This preliminary design feature allows for rapid intraoperative adjustment, reducing surgical time while achieving accurate graft placement.
Data Source
AI summary
An adjustable construct for fixation of a tendon or ligament graft in a tunnel. The construct comprises a flexible, adjustable loop connected to tissue (for example, graft, ligament or tendon). The adjustable loop may be integrated with an additional tissue supporting device (for example, a wedge or a plug). The tissue is secured within a bone socket/tunnel by adjusting the length of the flexible adjustable loop.