Knotless Patch Fixation for Stable Tissue-to-Bone Repair
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Solution Overview
Problem
Arthroscopic surgery for reattaching soft tissue to bone using patches is challenging due to increased handling, instrumentation, and time requirements, necessitating specialized skills.
Innovation Solution
A tensionable patch system with a patch and suture fixation devices, allowing for knotless fixation configurations like a double-row criss-cross pattern, where the patch is secured using suture anchor assemblies to distribute force evenly across the tissue and bone surface.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a patch is used for tissue-to-bone reattachment, then repair stability is improved, but handling time and instrumentation complexity increase
Solution Approach 1:
The patch is divided into multiple segments or rows with individual anchor points, allowing each section to be fixedated independently. This segmentation enables staged deployment where anchors are inserted and secured in sequence rather than requiring complete patch preparation beforehand, reducing overall handling time while maintaining repair stability through distributed fixation points
Solution Approach 2:
The patch is pre-configured with attached anchors and sutures in a controlled manufacturing environment, so that during surgery the patch arrives ready-for-use with all fixation components pre-positioned. This preliminary preparation eliminates time-consuming intraoperative assembly steps while ensuring proper anchor placement and tension distribution for stable repair
2Reliability
If a patch is used for tissue-to-bone reattachment, then repair stability is improved, but surgical skill requirements increase
Solution Approach 1:
The patch system incorporates self-aligning features and self-tensioning mechanisms that automatically adjust during deployment. The pre-attached anchors and sutures are designed to self-position at optimal locations, and the tensioning mechanism automatically distributes load evenly across fixation points, reducing the need for surgeon judgment and manual adjustment while ensuring consistent repair stability
Solution Approach 2:
The patch is designed with universal applicability through standardized anchor configurations and modular attachment points that can accommodate various tissue types and bone geometries. This multi-functional design allows the same patch system to be used across different surgical scenarios without requiring specialized techniques, thereby maintaining repair stability while reducing skill barriers
3Strength
If multiple anchors are used to secure the patch, then fixation strength is improved, but device complexity increases
Solution Approach 1:
Multiple individual anchor-suture assemblies are merged into a single integrated patch structure where all components are pre-assembled and pre-tensioned. This consolidation transforms what would be multiple separate implantation steps into a unified deployment process, maintaining the cumulative fixation strength of multiple anchors while reducing the perceived device complexity during surgery
4Reliability
If the patch is tensioned to improve fixation, then repair stability is improved, but handling difficulty increases
Solution Approach 1:
The patch incorporates dynamic tensioning mechanisms that allow progressive adjustment of tension levels during the surgical procedure. Rather than requiring high tension to be applied all at once, the system enables staged tensioning where the patch is initially secured with low tension and then progressively tightened, reducing handling difficulty while achieving the repair stability provided by high final tension
Data Source
AI summary
The invention relates to an improved method of double row tissue repair with a graft or patch at the repair site for various applications of arthroscopic surgery requiring tissue to bone attachment. The method includes a patch and one or more knotless, adjustable anchor systems that allow for knotless adjustability of the patch relative to the bone-tissue interface for proper positioning and securement of the patch at the repair site.