Biceps Button Fixation for Tendon Internalization
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Solution Overview
Problem
Current methods for biceps tendon repair in reconstructive surgeries, such as biceps tenodesis, often result in complications like gap formation and limited range of motion due to inadequate fixation techniques, particularly when using cortical buttons outside smaller drill holes.
Innovation Solution
The method involves converging two angled drill holes to secure a reinforced biceps tendon using a fixation device like the Arthrex BicepsButton™ or Pectoralis Button, ensuring stable fixation within a single bone socket, minimizing gap formation and optimizing biomechanics for immediate active range of motion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If cortical buttons are used for biceps tendon fixation, then tendon attachment strength is improved, but gap formation occurs and range of motion is limited
Solution Approach 1:
The fixation device is divided into multiple components: a button component that anchors to bone and a tendon attachment component that secures the tendon. This segmentation allows independent optimization of bone fixation strength and tendon mobility, resolving the contradiction between strong attachment and range of motion.
Solution Approach 2:
The fixation device incorporates dynamic elements that allow controlled movement and adaptation during healing. The device transitions from a rigid initial fixation to a more flexible state that accommodates physiological motion, enabling both strong initial attachment and progressive range of motion.
2Ease of operation
If larger drill holes are used for button fixation, then tendon internalization is improved, but bone structural integrity is compromised
Solution Approach 1:
The solution moves from a single large drill hole to multiple smaller drill holes arranged in a specific pattern. This dimensional redistribution allows the button to span across multiple holes, achieving adequate tendon internalization while preserving bone structural integrity through smaller, less invasive holes.
Solution Approach 2:
The button structure is designed to nest within the bone structure created by multiple small holes. The button components fit into and across the holes in a nested arrangement, achieving secure fixation without requiring a single large hole that would compromise bone integrity.
3Stability of the object's composition
If multiple fixation points are used, then tendon stability is improved, but device complexity increases
Solution Approach 1:
Multiple fixation functions are merged into a single integrated button device. The button combines bone anchoring, tendon attachment, and stability provision into one component that accomplishes multiple fixation objectives simultaneously, maintaining stability while minimizing device complexity.
Solution Approach 2:
The button device is designed as a universal fixation solution that performs multiple functions: anchoring to bone, securing the tendon, providing initial stability, and allowing for controlled motion. This multi-functionality eliminates the need for separate fixation components, reducing overall device complexity.
Data Source
AI summary
Methods and drill guide systems that provide internalization of the biceps tendon with use of fixation devices such as the Arthrex BicepsButton™ or Pectoralis Button tensioned outside a smaller converged drill hole. The technique converges two angled drill holes and use the button to fixate a reinforced (whipstitched) biceps tendon into a single bone versus stabilizing two bones. The biceps tendon is being pulled into the larger of the drilled holes and fixed by the button outside of the smaller drilled hole.