Hip Joint Capsule Retraction for Arthroscopic Access and Closure
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Accessing the hip joint for arthroscopic surgery is challenging due to the need to penetrate tough joint capsule tissue while avoiding damage to delicate structures, and existing methods require cumbersome distraction tables and multi-step procedures.
Innovation Solution
A method and apparatus for accessing the hip joint using a first device to secure to the capsule, followed by a second device to create a controlled penetration, and optionally a distension device to enlarge the working space, without the need for distraction tables.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If a needle is used to penetrate the joint capsule, then access to the joint interior is achieved, but the risk of damaging delicate structures (articular cartilage, blood vessels, nerves) increases
Solution Approach 1:
A guidewire serves as an intermediary element that is first inserted into the joint under fluoroscopic guidance, then used to guide the subsequent insertion of larger instruments. This intermediary approach allows precise positioning while reducing the risk of damaging delicate structures, as the guidewire can be carefully placed before introducing more substantial tools that would be difficult to position with the same precision.
Solution Approach 2:
Fluoroscopic imaging is performed preliminarily to identify safe insertion paths and locate delicate structures before the actual needle penetration. This preliminary visualization allows the surgeon to plan the approach and avoid harmful areas, reducing the risk of damaging articular cartilage, blood vessels, and nerves during the subsequent needle insertion.
2Volume of moving object
If distraction tables are used to create joint space, then working space is increased, but device complexity and procedural burden increase
Solution Approach 1:
The invention extracts the essential function of creating joint space from the complex distraction table system and achieves it through simpler means. By using a needle-guidewire technique with fluoroscopic guidance, the procedure creates sufficient working space without requiring the cumbersome distraction table equipment, thereby eliminating unnecessary device complexity while maintaining the essential function of joint space creation.
3Adaptability or versatility
If multiple access portals are created, then instrument access is improved, but the complexity of the procedure and time required increase
Solution Approach 1:
The guidewire technique serves as a universal access method that can be used for multiple different instruments and procedures. By establishing a single guidewire pathway, various instruments can be introduced through the same access point, eliminating the need to create multiple separate portals for different tools, thereby reducing procedural time and complexity.
Data Source
AI summary
A method for retracting a capsule of a joint includes forming a cut in the capsule to create a plurality of separated portions of the capsule. A first end of a first length of suture is passed through a first separated portion of the capsule and moved out of the joint. A first end of a second length of suture is passed through a second separated portion of the capsule and moved out of the joint. The first end and a second end of the first length of suture are pulled to retract the first separated portion of the capsule. The first end and a second end of the second length of suture are pulled to retract the second separated portion of the capsule. An arthroscopic procedure is performed in the joint, and the first length of suture and/or the second length of suture is used to close the capsule.