Fixable Suture Anchor Plate for Tendon-to-Bone Repair
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Solution Overview
Problem
Current methods for tendon-to-bone repair, such as bone-tunnel and suture-anchor techniques, face challenges in achieving stable fixation, especially in weak bone regions like the lateral metaphyseal bone of the proximal humerus, leading to high rates of repair failure and complications, and there is a need for a method that optimizes the tendon-to-bone interface, restores the tendon footprint, and minimizes synovial fluid intrusion.
Innovation Solution
A fixable suture anchor plate with a medial and lateral row of stitches secured by screws, which allows for decortication to enhance blood supply and distributes suture forces over a larger area, minimizing tendon motion and knot prominence, while preventing synovial fluid entry and securing the anchor plate to the bone with divergent screw axes for enhanced stability.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If suture anchors are placed in the lateral metaphyseal bone of the proximal humerus to perform tendon-to-bone repair, then the repair can be performed arthroscopically with stable fixation, but the suture anchors are prone to pull out of the weak bone, leading to repair failure
Solution Approach 1:
The fixation system is divided into two independent components: a suture anchor for tendon attachment and a separate bone plate for structural support. The bone plate is secured with multiple screws distributed across the bone surface, creating independent fixation points that prevent pull-out while allowing arthroscopic suture anchor insertion for tendon repair
2Strength
If multiple bone tunnels are created and multiple sutures are passed through them to secure the tendon to bone, then superior tendon fixation is achieved, but the sutures may cut through the soft lateral metaphyseal bone, leading to repair failure
Solution Approach 1:
A bone plate serves as an intermediary structure between the sutures and the bone. The sutures are secured to the bone plate rather than directly to the bone, distributing the tensile forces across multiple screw fixation points. This intermediary plate prevents the sutures from concentrating stress on small areas of soft bone, eliminating the cutting-through problem while maintaining strong tendon fixation
3Strength
If devices are designed to augment the lateral metaphyseal bone and are held in position by the suture, then bone support is provided, but if the suture breaks or tendon repair fails, the hardware migrates causing undesirable consequences
Solution Approach 1:
The fixation system separates the functions of tendon attachment and bone support into independent components. The bone plate with multiple screws provides independent structural support that does not depend on the suture integrity. Even if the suture breaks or tendon repair fails, the bone plate remains securely fixed to the bone through its own screw fixation, preventing hardware migration
Solution Approach 2:
The bone plate is pre-installed and secured with multiple screws before tendon attachment. This creates a pre-established stable framework that cushions and protects against the consequences of suture failure. The redundant screw fixation acts as a safety mechanism that prevents catastrophic hardware migration even if the primary suture attachment fails
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The solution provides strong, stable tendon-to-bone fixation, reduces suture pull-out and bone cutting, and effectively restores the tendon footprint, improving healing outcomes by distributing forces and maintaining blood supply, thus reducing the risk of repair failure and complications.
Implementation Method 1
a first thread adapted to threadedly engage the bone fixing the anchor plate to the bone
Implementation Method 2
a first thread adapted to threadedly engage the bone fixing the anchor plate to the bone
Implementation Method 3
divergent screw axes for enhanced stability
Data Source
AI summary
A fixable suture anchor plate including an anchor plate having a tunnel aperture that aligns with one or more bone tunnels formed in the bone. The anchor plate also includes one or more suture passages that align with one or more grooves formed along an edge of the anchor plate to permit passing a suture through the anchor plate after the anchor plate is fixed to the bone. The anchor plate also includes a screw hole that allows the anchor plate to be fixed to a bone with a screw. A method for tendon-to-bone repair includes sewing a medial row of stitches proximate to a medial line of tendon-to-bone attachment and securing the suture to the anchor plate through a bone tunnel and sewing a lateral row of stitches along a lateral line of tendon-to-bone attachment and securing the second suture to the anchor plate.