Forked Graft Introducer with Tensioned Suture for Bone Tunnel Insertion
Solution Overview
Problem
Existing surgical instruments face challenges in internalizing graft tissue during procedures like tenodesis, as the graft tissue tends to compress against the instrument and move from its desired position due to frictional contact, making it difficult to position the tendon within a bone tunnel without externalizing the tissue.
Innovation Solution
A surgical instrument with a forked distal end and a flexible member spanning the space between the tines allows for the graft to be manipulated into a bone hole, with adjustable tension to maintain the graft's position and facilitate its insertion, and a guide wire for precise placement.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If the graft tissue is internalized within the patient, then the surgical procedure becomes less invasive and more precise, but the graft tissue tends to compress against the instrument and move from its desired position due to frictional contact
Solution Approach 1:
The instrument is divided into multiple functional segments: a shaft for insertion, a forked distal end with first and second tines for gripping, and a flexible member spanning the tines for tension control. This segmentation allows each component to address specific challenges in graft manipulation and positioning.
Solution Approach 2:
The flexible member spanning the tines can be dynamically adjusted in tension to control the spacing between tines. By varying the tension, the instrument can adapt to different graft sizes and maintain optimal gripping pressure while preventing compression and displacement of the graft tissue during insertion.
2Ease of manufacture
If the graft tissue is externalized and whip stitched to make a stiff construct, then the graft can be pushed directly into the tunnel, but the surgical procedure becomes more complex and less precise
Solution Approach 1:
The flexible member acts as an intermediary element between the surgeon's manual manipulation and the graft tissue. It provides a controlled interface for gripping and advancing the graft internally, eliminating the need for externalization and complex whip stitching while maintaining precise control over the graft's position and orientation.
3Ease of operation
If the graft tissue is folded near the location of tunnel and pushed into the tunnel at the fold, then the graft can be inserted, but the frictional contact between the graft tissue and instrument causes the tissue to move from its desired position
Solution Approach 1:
The flexible member is pre-configured with appropriate tension to establish the correct spacing between tines before graft insertion. This preliminary setup ensures that the graft is gripped at the optimal location and maintained in the desired position throughout the insertion process, preventing displacement due to frictional contact.
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
Enables the internalized graft tissue to be accurately positioned within the bone tunnel without externalization, ensuring the graft remains in place during implantation, improving the surgical efficiency and precision.
Implementation Method 1
A flexible member spans the space between the first tine and the second tine so that the graft can be received within the space against the flexible member and thereby manipulated into the bone hole
Implementation Method 2
the flexible member having a first section between the first tine and second tine, and a second section extending from the first notch proximally along the handle where it preferably, is releasably attached to the handle so that a user can release the flexible member from the handle to relax tension in the flexible member
Implementation Method 3
the first tine and second tine are curved about a central longitudinal axis of the instrument to accommodate to the bone hole
Data Source
AI summary
An instrument for placing a graft into a bone tunnel comprises an elongated shaft having a forked distal end comprising a pair of tines. A suture spans a space defined between the tines whereby the graft may be positioned between the tines and against the suture so as to be manipulated into the bone tunnel. The tendon folds about the suture, the suture having a releasable tension such that the instrument can be removed from the bone, leaving the tendon behind without the tendon hanging up on the suture.