Arthroscopic Shoulder Implant Assembly via Segmented Insertion
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Solution Overview
Problem
Conventional shoulder joint replacement surgeries require extensive surgical exposure, leading to damage to surrounding muscles and tendons, resulting in longer healing times and the need for extensive physical therapy, and are not suitable for patients with prior trauma or deformity, as existing implants are bulky and require conventional extensive approaches.
Innovation Solution
The development of a novel arthroscopic method and instrumentation for inserting shoulder prosthesis components through minimal incisions, using an osteotomy guide, mechanical center locator, and specialized tools to assemble the humeral and glenoid components within the shoulder joint, minimizing tissue damage and allowing for stem-free or stemless implantation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional extensile surgical approach is used for shoulder prosthesis insertion, then complete implantation is achieved, but significant damage to surrounding muscles and tendons occurs
Solution Approach 1:
The surgical procedure is segmented into multiple minimally invasive arthroscopic portals instead of a single large incision. Instruments and implant components are introduced through separate small portals, allowing complete implantation while minimizing tissue disruption to muscles and tendons.
Solution Approach 2:
Implant components are assembled in a nested manner where the humeral stem is inserted first, followed by the humeral head, and finally the glenoid component. This nested assembly approach allows complete implantation through sequential insertion through small portals without requiring extensive surgical exposure.
2Reliability
If conventional extensile surgical approach is used, then implantation is complete, but longer healing period is required
Solution Approach 1:
By segmenting the surgical approach into multiple small arthroscopic portals rather than one large incision, the trauma to soft tissues is dramatically reduced. This segmentation allows the same complete implantation to be achieved with minimal tissue disruption, thereby shortening the healing period.
Solution Approach 2:
Patient-specific instruments and guides are prepared in advance based on preoperative planning. This preliminary preparation allows for precise, efficient implantation through small portals during surgery, reducing operative time and tissue trauma, which directly shortens the postoperative healing period.
3Reliability
If conventional extensile surgical approach is used, then implantation is complete, but extensive postoperative physical therapy is required
Solution Approach 1:
The arthroscopic segmented approach preserves the integrity of surrounding muscles and tendons by avoiding large incisions and extensive retraction. This preservation of soft tissue structures means less postoperative pain and stiffness, reducing the burden of physical therapy while still achieving complete and reliable implantation.
4Object-affected harmful factors
If stem-free or stemless humeral component is used, then trauma to proximal humerus is avoided, but components are bulky and require conventional extensive surgical approach
Solution Approach 1:
The stemless humeral component is divided into separate insertion segments that can be introduced through small arthroscopic portals. The implantation process itself is segmented into sequential steps (portal creation, component insertion, fixation) that avoid the need for large incisions, thereby preventing trauma to the proximal humerus while avoiding the bulkiness problem.
5Object-affected harmful factors
If arthroscopic method with minimal incisions is used, then damage to surrounding muscles and tendons is minimized, but surgical precision and component assembly difficulty increase
Solution Approach 1:
Patient-specific instruments, guides, and templates are manufactured in advance based on preoperative imaging and planning. These custom tools are designed to fit the patient's unique anatomy and provide built-in alignment and positioning features, thereby reducing the precision burden on the surgeon during the actual arthroscopic procedure while still achieving accurate component placement through minimal incisions.
Data Source
AI summary
A novel method and instrumentation for insertion of humeral and glenoid total shoulder implant using arthroscopic visualization for bony preparation as well as insertion of components through small incisions. Mini instruments and cannulated guides and reamers are used in order to perform the procedure under direct arthroscopic visualization. For ease of insertion, the components are inserted separately and assembled in situ. Securing the humeral components in place is accomplished with bicortical screw transfixing the central peg of component. Also disclosed are components, parts thereof and instruments used therewith.