Adjustable Suture Syndesmosis Fixation for Joint Stability
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Solution Overview
Problem
Current implants for stabilizing the distal tibiofibular joint, such as cortical screws and the TightRope implant, face issues with hardware failure, joint stiffness, and inadequate stability, particularly in cases of ankle instability and fractures, where direct ligament repair is challenging due to diagnostic and surgical limitations.
Innovation Solution
The use of self-locking, adjustable suture loops anchored in the lateral tibia that extend around the fibula, mimicking native ligaments to provide multiple tension stabilization vectors and facilitate joint reduction, thereby improving stability and reducing the need for hardware removal surgery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Stability of the object's composition
If cortical screws are used to stabilize the distal tibiofibular joint, then excellent stabilization is achieved, but the screws commonly fail or restrict motion of the joint, leading to the need for hardware removal surgery
Solution Approach 1:
The patent employs a flexible suture construct (TightRope implant) instead of rigid cortical screws. The flexible suture member allows for motion while providing stabilization, preventing the joint from becoming stiff while avoiding hardware failure. The flexible nature of the suture construct enables it to accommodate joint movement without breaking or causing restrictive stiffness.
Solution Approach 2:
The patent changes the mechanical properties of the stabilization construct from rigid (screw) to flexible (suture). This parameter change allows the construct to maintain stability while accommodating joint motion, thereby reducing hardware failure and the need for removal surgery.
2Stability of the object's composition
If rigid implants are used to stabilize the joint, then stabilization is achieved, but joint stiffness and broken hardware occur
Solution Approach 1:
The patent uses a flexible suture construct that maintains joint stabilization while allowing physiological motion. The flexible nature of the suture prevents the joint from becoming stiff, as the construct can deform and adapt to joint movement rather than rigidly constraining it.
3Ease of operation
If a single TightRope implant is used, then flexibility is maintained, but adequate stability is not provided for multiple degrees of freedom
Solution Approach 1:
The patent employs multiple suture constructs (typically two or more TightRope implants) rather than relying on a single construct. Each suture construct provides stabilization in different planes, collectively addressing multiple degrees of freedom while maintaining joint flexibility and mobility.
Solution Approach 2:
The patent uses multiple suture constructs arranged in different spatial orientations to control motion in multiple degrees of freedom. By distributing stabilization across multiple dimensions and planes, the construct provides comprehensive stability while preserving joint flexibility.
4Ease of manufacture
If reduction is performed as a separate preceding step, then implant delivery is facilitated, but the implants do not directly address the need for correction
Solution Approach 1:
The patent incorporates reduction capability directly into the suture construct design, allowing the surgeon to perform reduction and stabilization in a single integrated procedure. The suture construct is designed to facilitate reduction while providing stabilization, eliminating the need for separate reduction and fixation steps.
Data Source
AI summary
A method for syndesmosis fixation including at least one suture anchor configured to be implanted into bone and at least one suture assembly configured to extend from the suture anchor and about at least a portion of a fibula when the suture anchor is implanted in a tibia on either side of a fibular notch of the tibia. The suture assembly is selectively adjustable from a non-tensioned condition to a tensioned condition to stabilize and reduce the fibula relative to the tibia.