Adjustable Suture-Button Construct for Ligament Reconstruction
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Solution Overview
Problem
Surgical PCL reconstruction is challenging due to the difficult placement of new grafts and the tendency of replacement grafts to stretch and become less functional over time, with existing fixation systems not effectively addressing these issues for PCL and other ligaments like ACL and collateral ligaments.
Innovation Solution
A knotless, adjustable suture loop construct with a removable, detachable button and a fixed, non-removable button provides variable-length graft support, allowing for adjustable fixation during and after deployment, facilitating minimally invasive PCL reconstruction and potentially applicable to ACL and collateral ligaments.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional fixation systems are used for PCL reconstruction, then the surgical procedure can be performed, but the graft is prone to stretching and becoming less functional over time
Solution Approach 1:
The suture construct incorporates an adjustable mechanism that allows dynamic modification of the graft length and tension during the healing process. The construct can be adjusted from a relaxed state post-operatively to a more tensioned state if graft stretching is detected, providing adaptive control over graft stability rather than relying on a fixed, non-adjustable fixation system.
Solution Approach 2:
The invention enables change in the physical parameters of the graft construct, specifically the length and tension, through adjustable mechanisms. The suture buttons and loops can be modified to alter the graft's mechanical properties, allowing the system to adapt to changing physiological conditions and prevent graft stretching over time.
2Reliability
If adjustable suture-button constructs are used, then graft fixation stability is improved, but the device complexity increases
Solution Approach 1:
The suture construct is divided into discrete, modular components including suture buttons, loops, and graft elements. This segmentation allows for simplified assembly and adjustment procedures while maintaining overall stability. Each component can be independently manipulated during surgery, reducing the complexity of handling the entire construct at once.
Solution Approach 2:
The adjustable mechanism is designed to be self-adjusting through the surgeon's manual manipulation during the procedure. The construct incorporates features that allow the surgeon to modify graft tension and length through simple pulling or releasing actions on the suture buttons, eliminating the need for complex mechanical adjustment devices or additional tools.
3Object-affected harmful factors
If minimally invasive approach is used for PCL reconstruction, then surgical trauma is reduced, but the difficulty of graft placement increases
Solution Approach 1:
The suture construct is pre-assembled with the graft and fixation elements before insertion into the knee joint. This preliminary preparation allows the entire construct to be introduced through a minimally invasive portal as a single unit, avoiding the need for complex intra-articular manipulation during the procedure while still achieving stable graft fixation.
Data Source
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AI summary
An adjustable suture-button construct for ligament reconstruction. The construct is a knotless, adjustable, flexible suture loop, a first fixation device (a free or removable slotted button) and optionally a second fixation device (a fixed, non-removable button). Suture ends of the knotless suture loop provide a variable-length graft support that can be adjusted prior to, during, or after deployment of the constructs. The removable, detachable fixation device is provided with attachment feature(s) to permit assembly onto the adjustable loop. The removable, detachable fixation device is attached to the tibia end of the loop construct after the loop construct is passed through the tibial tunnel (i.e., once the loop exits the anterior tibia cortex). If a fixed, non-removable button is employed, the fixed, non-removable button is securely attached (by stitching, for example) to the graft.