Arthroscopic Tenodesis Guide and Inserter System
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Solution Overview
Problem
Current arthroscopic tendon fixation methods require dedicated interference screws, are hindered by large inserter sizes blocking visibility, and necessitate additional implants, leading to complex procedures and increased costs.
Innovation Solution
An arthroscopic guide and inserter system that allows for temporary tendon fixation using a cannulated fixation screw, eliminating the need for dedicated screws and additional implants, while improving visibility and reducing procedure steps.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If a dedicated interference screw or fixation device is used, then the tendon can be fixed to the bone, but the device cannot be used with a wide variety of cannulated interference screws and requires additional implants
Solution Approach 1:
The guide is designed with a universal interface that can accommodate various cannulated interference screws and fixation devices. The guide's elongate member with major outer dimension smaller than the cannula of the fixation screw allows it to work with a wide variety of screw types, eliminating the need for dedicated fixation devices for each screw type.
Solution Approach 2:
The guide combines multiple functions into a single device: it serves as a delivery mechanism for the tendon, a positioning tool for the fixation screw, and a temporary anchor during insertion. This integration eliminates the need for separate dedicated interference screws or additional implants, reducing overall device complexity.
2Reliability
If a large inserter and implant assembly is used, then the tendon can be fixed to the bone, but the large size blocks arthroscopic view of the tunnel and impedes surgeon performance
Solution Approach 1:
The system is divided into separate components: a small guide that remains in the tunnel for positioning, and a separate inserter that is used to deliver the tendon and then removed. This segmentation allows the surgeon to use a minimal-profile guide during the critical positioning phase, maintaining clear arthroscopic visibility while ensuring reliable tendon fixation.
Solution Approach 2:
The inserter is extracted from the tunnel after delivering the tendon to the guide. By removing the large inserter assembly after its delivery function is complete, the surgeon regains unobstructed arthroscopic view of the tunnel for subsequent screw insertion and fixation, while the tendon remains securely positioned by the guide.
3Device complexity
If temporary fixation of the tendon to bone is not enabled, then the procedure can be simpler, but the tendon has a tendency to wrap around the interference screw during insertion making the procedure more complex
Solution Approach 1:
The guide is inserted into the bone tunnel before the tendon and fixation screw. This preliminary positioning creates a predetermined pathway and temporary anchor point that guides the tendon into correct position and prevents wrapping during subsequent screw insertion, ensuring reliable tendon positioning while maintaining procedural efficiency.
Solution Approach 2:
The guide serves as an intermediary structure between the tendon and the fixation screw. It provides a temporary mechanical anchor that holds the tendon in the correct position during screw insertion, preventing the tendon from wrapping around the screw. After the screw is inserted, the guide is removed, having fulfilled its mediating function.
4Reliability
If a second separate implant is used, then the tendon can be fixed to the bone, but it adds cost to the procedure and a second implant remains in the body after the procedure
Solution Approach 1:
The guide is designed as a temporary implant that is discarded after its function is complete. It is inserted to provide temporary fixation and positioning, then removed after the permanent fixation screw is inserted and the tendon is securely attached. This eliminates the need for a second permanent implant while maintaining reliable tendon fixation.
Data Source
AI summary
An arthroscopic tenodesis kit, including a guide with an elongate member having a length with a distal portion having a notch configured to releasably engage a suture; a cannulated fixation screw having a longitudinal cannula configured to receive the guide; and an inserter. The inserter includes an elongate cannulated body having an interior bore having a blind end and an open end configured to slidingly receive the guide. The body of the inserter has a length that is shorter than the length of the guide, so that the distal portion of the guide remains spaced from the bore when the guide is fully received within the bore.