Bone-Tendon-Bone Implants With Adjustable Knotless Suture Coupling
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Solution Overview
Problem
Existing suture and anchor methods for securing soft tissues to bone are time-consuming and limited by the strength of knots, which can be improperly tied, leading to reduced tensile strength.
Innovation Solution
A braided tubular suture with strategically placed apertures allows for the formation of adjustable loops that can be tensioned to securely fasten soft tissues to bone without the need for knots, using locking members and adjustable suture constructs to stabilize anatomical features.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional sutures and anchors are used to secure soft tissues to bone, then the procedure can be performed, but the procedure becomes time-consuming and the strength is limited by the knot
Solution Approach 1:
The invention extracts the knot-tying step from the surgical procedure by using a preformed loop suture configuration. The loop is created during manufacturing rather than during surgery, eliminating the time-consuming knot-tying process while maintaining the security and strength of the tissue anchor.
Solution Approach 2:
The suture loop is preformed during manufacturing before the actual surgical application. This preliminary action of creating the loop structure in advance allows the surgeon to simply insert and tension the suture without needing to tie knots during the procedure, thereby saving time while ensuring consistent loop formation.
2Productivity
If traditional sutures with preformed loops are used, then the procedure time is reduced, but the tension may be lost when the suture translates back through the passage
Solution Approach 1:
The suture construction is segmented into multiple components: the braided tubular body with internal passage, the preformed loop structure, and the aperture system. This segmentation allows the suture to be passed through bone tunnels and tissue in a controlled manner while maintaining tension through the aperture configuration that prevents backward translation.
Solution Approach 2:
The braided tubular structure with internal passage acts as an intermediary mechanism that guides and constrains the suture ends. The apertures positioned along the tube serve as intermediaries that control the path of the suture, ensuring that when tension is applied, the loop constricts properly and the suture cannot translate back through the passage to lose tension.
3Strength
If knots are used to secure sutures, then the suture can be anchored, but the strength of the repair is limited by the knot strength which may be significantly lower than the tensile strength of the suture material
Solution Approach 1:
The invention completely removes the knot from the system by using a preformed loop configuration. The loop is created during manufacturing with precise geometry that ensures proper tissue engagement. This extraction eliminates the weak point represented by the knot, allowing the full tensile strength of the suture material to be utilized without being compromised by improper knot tying.
Solution Approach 2:
The loop structure is preliminarily formed during manufacturing with exact dimensional specifications. This preformed loop ensures consistent geometry and proper orientation before surgical insertion, eliminating the variability and potential errors associated with manual knot tying while maintaining the anchoring function.
Data Source
AI summary
A method of coupling a first portion of an anatomy to a second portion of the anatomy includes coupling first and second bones of the anatomy with a bone-tendon-bone implant. The bone-tendon-bone implant has a first bone end, a second bone end and a replacement tendon between the first and second bone ends. The first and second bone ends are positioned in corresponding first and second bores of the first and second bones. The first bone end is secured to the first bone with a first bone anchor. A second anchor coupled to the bone-tendon-bone implant is passed through and outside the second bore. The second anchor is coupled to an adjustable suture construct having two adjustable suture loops. Tensioning at least one of first and second ends of the adjustable suture construct tensions the replacement tendon and positions the first bone relative to the second bone.