Knotless Micro Suture Anchor Arrays for High-Density Tendon Repair
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Solution Overview
Problem
Existing arthroscopic methods for attaching tendons to bone, particularly in rotator cuff repairs, suffer from high failure rates, significant variation between surgeons, and prolonged recovery times, necessitating improved devices and methods for secure and anatomical reattachment with reduced micromotion and enhanced healing.
Innovation Solution
A high-density array of knotless micro suture anchors is used, implanted through the tendon (transtendinous) with a delivery system, providing a robust and anatomical repair by securing the tendon to its original footprint, utilizing a pre-strung suture system with independent locking mechanisms to minimize sliding and enhance healing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of time
If all-arthroscopic techniques are used for rotator cuff repair, then recovery time is reduced and surgical trauma is minimized, but the procedure becomes difficult to perform and achieves varying results with high failure rates
Solution Approach 1:
The suture anchor is divided into multiple independent toggle components (first toggle, second toggle, third toggle) that can be independently deployed and tensioned. This segmentation allows for more precise control over suture tension distribution across multiple attachment points, improving repair reliability while maintaining the minimally invasive arthroscopic approach
Solution Approach 2:
The suture is pre-threaded through all toggle components before implantation, creating a pre-configured tensioning system. This preliminary arrangement ensures that when the toggles are deployed, the suture tension is automatically distributed according to the predetermined configuration, reducing surgeon skill variability and improving consistent repair outcomes
2Strength
If traditional suture anchors with knots are used, then tendon attachment is achieved, but knot sliding causes micromotion that delays healing and increases failure risk
Solution Approach 1:
The traditional knotted suture system is replaced with a toggle-based mechanical locking system. The toggles engage with the suture in a non-slip manner through geometric interlocking, eliminating the sliding and micromotion problems associated with knots while maintaining strong tendon-to-bone attachment
Solution Approach 2:
The suture configuration is changed from a simple knotted loop to a complex multi-toggle arrangement with specific geometric parameters. The toggles are positioned at predetermined intervals along the suture, creating a distributed tensioning system that reduces local stress concentrations and minimizes micromotion at the attachment site
3Reliability
If a high-density array of micro suture anchors is implanted, then repair reliability increases and recovery time decreases, but the device complexity and surgical precision requirements increase
Solution Approach 1:
Multiple suture anchors and their associated toggles are merged into a single integrated implantable unit. This consolidation allows the entire high-density array to be deployed as one component, eliminating the need for individual anchor placement and reducing the precision requirements while maintaining the benefits of multiple attachment points
Solution Approach 2:
The suture anchor system is designed to perform multiple functions simultaneously: it provides mechanical attachment, distributes tension across multiple points, and self-tensions through the toggle mechanism. This multi-functionality allows a single device to achieve the benefits of a high-density array without requiring multiple separate implantation steps
Data Source
AI summary
A system of toggle type suture anchors is disclosed. The plurality of suture anchors is connected in series by a single working suture and each of the suture anchors allows tensioning of the working suture between itself and the prior anchor implanted in the serial string. Further, each anchor includes a loop type locking mechanism to lock the working suture in place subsequent to tensioning. This creates an independently tensioned suture stitch between each implanted suture anchor and the just previously implanted anchor. In total the system as implanted creates a continuous array of single anchor to anchor stitches which can be placed close together in high density to form a line or region of stitches for a more robust securement of soft tissue to bone.