Knotless Double-Row Suture Construct for Rotator Cuff Repair
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Solution Overview
Problem
Existing methods for arthroscopic rotator cuff repairs using knotless fixation devices face challenges in securely attaching a graft or patch to the repair site without the need for insertion of fixation devices through the graft or patch, which complicates the surgical procedure and handling.
Innovation Solution
A method of forming a knotless double row construct where medial anchors with attached suture or tape are used to create loops, allowing traction sutures to pull a graft or patch into position underneath the tissue, and lateral anchors secure the construct without the need for fixation devices through the graft or patch.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If fixation devices are inserted through the graft or patch to secure it at the repair site, then the graft or patch can be securely fixedated, but the surgical procedure becomes more complex and difficult to handle
Solution Approach 1:
The patent uses suture anchors with loops as intermediary elements to transfer the graft or patch to the repair site without inserting fixation devices through the graft itself. The suture anchors are固定在骨头上，their loops allow the graft to be pulled through and secured, eliminating the need for direct fixation device insertion through the graft material and simplifying the surgical procedure
2Adaptability or versatility
If the graft or patch is held in a free state during introduction, then it can be positioned at the repair site, but increased handling and instrumentation are required
Solution Approach 1:
The patent performs preliminary action by pre-securing the graft or patch to the suture anchors before introduction to the repair site. The suture anchors with attached suture tails are used to pre-position and hold the graft in place during introduction, eliminating the need for separate handling instruments and reducing surgical complexity
3Strength
If multiple fixation devices are used to secure the graft or patch, then fixation strength is improved, but the insertion process becomes more difficult and time-consuming
Solution Approach 1:
The patent merges multiple functions into the suture anchor system: the suture anchors provide both the fixation to bone and the mechanism for graft transfer. The suture tails serve dual purposes of securing the anchor in bone and pulling the graft through, eliminating the need for separate fixation devices and reducing surgical steps
Data Source
AI summary
Systems and methods for soft tissue to bone repairs, without knot tying. The soft tissue repair includes the steps of (i) providing a medial row formed of a plurality of medial anchors, the medial anchors comprising suture or tape attached to each of the bodies of the medial anchors, the suture or tape forming a loop when the medial anchors are placed within tissue; (ii) passing traction sutures through each of the corresponding loop of the nearest medial anchor; (iii) passing through the tissue (rotator cuff) the free limbs of the suture or tape attached to each of the medial anchors, and one end of the traction suture (passed through the corresponding loop) at their respective points; (iv) bringing the other end of the traction suture (through a lateral cannula) underneath the tissue (the rotator cuff) and then securing the passed end of the traction suture to a graft or patch located underneath the tissue (rotator cuff); and (v) adjusting the position of the graft or patch by pulling end of the traction suture passed through the tissue (rotator cuff).