Adjustable Suture Button Fixation for Stable ACL Graft Tensioning

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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 secure graft fixation without pre-calculating graft length, incorporating a self-locking mechanism to prevent loosening and minimize micromotion, using a graft supporting device to enhance tunnel compression.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If precise calculation of graft length is performed, then accurate graft placement is achieved, but the procedure becomes complex and time-consuming

Engineering Contradiction:

Improvegraft length determinationVSAvoidfixation technique complexity

Core Design Contradiction:

Measurement precisionVSDevice complexity

Solution Approach 1:

The button construct with adjustable suture loop allows the surgeon to determine graft length intraoperatively by simply pulling the suture to achieve proper tension, eliminating the need for complex pre-calculations. The system self-adjusts to the correct length through direct manipulation during surgery.

Inventive Principle:

Principle #25Self-service

Solution Approach 2:

The suture loop length is made dynamically adjustable during the surgical procedure rather than being fixed in advance. This allows real-time optimization of graft length based on actual anatomical conditions without requiring complex preoperative planning.

Inventive Principle:

Principle #15Dynamics

2Reliability

If interference screw fixation is used, then graft fixation is achieved, but graft loosening and tunnel widening occur due to micromotion

Engineering Contradiction:

Improvegraft fixation stabilityVSAvoidmicromotion-induced tunnel widening

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The button construct acts as an intermediary device between the graft and bone, distributing loads more evenly and reducing micromotion at the graft-bone interface. The suture loop provides a compliant connection that accommodates physiological movement while maintaining secure fixation.

Inventive Principle:

Principle #24Intermediary (Mediator)

Solution Approach 2:

The fixation mechanism changes from rigid interference screw fixation to a more compliant suture-based system that allows controlled movement. This parameter change in fixation rigidity reduces stress shielding and micromotion-related complications while maintaining stability.

Inventive Principle:

Principle #35Parameter changes

3Ease of operation

If adjustable suture loop is used, then graft length can be determined intraoperatively, but additional surgical steps are required

Engineering Contradiction:

Improvegraft length determinationVSAvoidsurgical procedure efficiency

Core Design Contradiction:

Ease of operationVSProductivity

Solution Approach 1:

The button and suture loop are pre-assembled as a single construct before surgery, eliminating the need for complex intraoperative assembly. This preliminary preparation reduces surgical steps while maintaining the advantage of intraoperative length adjustment.

Inventive Principle:

Principle #10Preliminary action

Data Source

PatentUS20260033939A1Adjustable suture button construct

Publication Date: 2026.02.05 ARTHREX INC

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.