Joint Kinematic Reconstruction Using Suture Shuttle Graft Fixation
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Solution Overview
Problem
Unstable joints, often resulting from significant disruption of articulating bones or surrounding soft tissues, lead to pain, dysfunction, accelerated bone loss, and premature arthritis, with existing solutions failing to effectively restore joint kinematics, especially in cases of irreparable rotator cuff tears post-arthroplasty.
Innovation Solution
The method involves fixating a graft to the articulating bones using sutures and suture anchors, sizing the graft based on precise measurements, and using a pulley technique to shuttle the graft into the joint space for secure fixation, which can be applied in various joints, including the shoulder, to improve joint kinematics.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If arthroplasty is performed to treat unstable joints, then joint replacement is achieved, but joint preservation is lost and long-term function is compromised
Solution Approach 1:
The patent extracts and removes the unstable labrum tissue from the joint, then replaces it with a synthetic graft material that can be securely fixed to the bone. This extraction of the problematic tissue followed by replacement with stable synthetic material resolves the instability issue while preserving the joint structure for long-term function.
Solution Approach 2:
The patent uses composite construction by combining synthetic graft material with bone anchors and sutures to create a reinforced labral reconstruction. This composite approach provides both the structural integrity needed for stability and the biological compatibility required for joint preservation, overcoming the limitations of simple replacement.
2Strength
If graft fixation is performed inside the joint space, then secure attachment is achieved, but surgical access and visualization are compromised
Solution Approach 1:
The patent performs preliminary actions by placing bone anchors in the glenoid bone before inserting the graft. The sutures are then threaded through these pre-placed anchors, allowing the graft to be securely fixed without requiring complex internal fixation procedures. This preliminary preparation simplifies the overall surgical access and visualization requirements.
Solution Approach 2:
The patent uses sutures as intermediary elements that connect the graft to the bone anchors. These sutures serve as a mediator that allows secure fixation while maintaining surgical accessibility, as they can be manipulated through the joint space from external approaches rather than requiring direct internal fixation mechanisms.
3Manufacturing precision
If multiple measurements are taken between suture anchors, then precise graft sizing is achieved, but surgical time and complexity increase
Solution Approach 1:
The patent makes the suture anchors serve multiple functions: they provide fixation points for the graft, serve as measurement references for sizing, and guide the placement of sutures. By making the anchors multi-functional, the patent eliminates the need for separate measurement tools and procedures, thereby reducing surgical time while maintaining precise graft sizing.
Solution Approach 2:
The suture anchors perform self-service by simultaneously providing structural fixation and measurement reference points. The anchors are designed with features that allow direct measurement between them during surgery, enabling the surgical team to size the graft precisely using the anchors themselves rather than requiring additional specialized instruments or time-consuming measurement procedures.
Data Source
AI summary
A method for reconstructing a joint according to an exemplary aspect of the present disclosure includes, among other things, fixating at least one suture inside a joint space, retrieving the at least one suture from inside the joint space, passing the at least one suture through a graft at a location external to the joint space, shuttling the graft into the joint space, and fixating the graft using the at least one suture.