Knee Replacement Soft Tissue Preservation via VMO Retraction
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Solution Overview
Problem
Traditional knee replacement surgeries involve cutting the vastus medialis obliques (VMO) muscle and quadriceps tendon, leading to patient pain and complications during rehabilitation.
Innovation Solution
Perform a medial oblique incision and retract the VMO muscle to maintain its integrity, using various retractors to expose the knee joint without cutting, and employ a unique patella eversion technique with intact soft tissues.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If traditional knee replacement surgery cuts the VMO muscle and quadriceps tendon to access the knee joint, then surgical access is improved, but patient trauma and post-surgical pain increase
Solution Approach 1:
The surgical approach is segmented into distinct phases: making the incision, retracting the VMO muscle laterally, and then accessing the knee joint. This segmentation allows the surgeon to achieve necessary exposure without cutting the VMO muscle or quadriceps tendon, thereby reducing patient trauma while maintaining surgical access.
Solution Approach 2:
A retractor is introduced as an intermediary tool to laterally displace the VMO muscle and create space for surgical access. This intermediary device enables the surgeon to access the knee joint without directly cutting the soft tissues, thus resolving the contradiction between surgical access and patient trauma.
2Ease of operation
If the VMO muscle is cut to facilitate access to the patella and knee joint, then surgical access is improved, but subsequent suturing is required which increases patient pain and complications
Solution Approach 1:
The surgical approach is planned and executed in advance to specifically avoid cutting the VMO muscle and quadriceps tendon. By preliminarily determining the incision path and retraction strategy, the surgeon can gain access to the knee joint without compromising the soft tissues, thereby eliminating the need for suturing and reducing post-surgery complications.
Solution Approach 2:
The natural lateral position of the VMO muscle is utilized to the surgeon's advantage. Instead of cutting through the muscle, the surgeon exploits its lateral positioning by applying lateral retraction, which naturally creates the necessary surgical corridor without tissue disruption. This converts what could be a harmful cutting action into a beneficial non-invasive retraction approach.
3Ease of operation
If soft tissues are cut during knee replacement surgery, then access to the knee joint is improved, but soft tissue integrity is compromised
Solution Approach 1:
The surgical approach employs dynamic retraction of the VMO muscle rather than static cutting. The retractor allows for adjustable, reversible displacement of the soft tissue, maintaining its integrity while providing the necessary dynamic access to the knee joint throughout the surgical procedure.
Solution Approach 2:
A retractor serves as an intermediary between the surgical field and the VMO muscle, allowing joint exposure without direct contact or cutting of the soft tissue. This intermediary tool maintains soft tissue integrity while achieving the desired joint exposure for the replacement procedure.
Data Source
AI summary
A surgical method that preserves soft tissue is provided. A medial oblique incision is performed in a patient's knee so that the knee's vastus medialis obliques (VMO) muscle and quadriceps tendon remain intact and uncut. The VMO muscle is then retracted to expose the knee's distal femur. The knee's distal femur may then be repaired as the in-tact VMO muscle is retracted.