Knotless Tensionable Suture Construct for Soft Tissue Retention
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Solution Overview
Problem
Existing surgical techniques for reattaching detached soft tissue, such as ligaments or tendons, require tying knots in sutures, which cannot be adjusted for additional tension or repositioned, limiting the ability to retension or reattach tissue securely.
Innovation Solution
A knotless tensionable suture construct using a self-tensioning suture loop with a metal needle, a single strand of suture, a large knot, and a 'Chinese finger trap' mechanism, allowing for adjustable tension without knots, connected to a fixation device like a bone plate with recessed suture eyelets for secure tissue attachment and reattachment.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If knots are tied in the suture to secure tissue attachment, then the suture is anchored securely to bone and tissue, but the suture cannot be adjusted for additional tension or repositioned
Solution Approach 1:
The invention removes the knot from the suture construct entirely, extracting the problematic element that prevented adjustment. Instead of tying knots to secure the suture, the patent uses a knotless suture loop with a bulbous end that engages with a fixation device, allowing the suture to be secured without the restrictive knot structure.
Solution Approach 2:
The suture construct transitions from a static, non-adjustable knotted state to a dynamic, adjustable state. The knotless suture loop with its bulbous end can be engaged and disengaged from the fixation device, and the suture tension can be modified by adjusting the loop configuration, enabling dynamic adaptation after implantation.
2Device complexity
If a simple suture loop is used for tissue attachment, then the construct is simple and easy to implement, but it lacks the security and reliability of knotted sutures
Solution Approach 1:
The suture loop is designed with an asymmetric bulbous end that is larger than the loop portion. This asymmetric geometry provides mechanical engagement with the fixation device, where the bulbous end engages with the fixation device's retention feature, creating a secure attachment without requiring knots while maintaining relative simplicity.
3Ease of operation
If traditional knotted suture techniques are used, then the method is well-established and easy to perform, but it cannot provide retensioning capability when additional tension is required
Solution Approach 1:
The knotless suture loop construct allows for dynamic adjustment of suture tension after the initial surgical procedure. The bulbous end can be disengaged and re-engaged with the fixation device, and the loop can be reconfigured to adjust tension, providing retensioning capability while maintaining relative surgical simplicity through the knotless design.
Data Source
AI summary
Apparatus and methods for tissue fixation/attachment/reattachment using a knotless tensionable suture construct. The knotless tensionable suture construct is a self-tensioning suture loop that can be tensioned and retensioned after the repair and can be cycled few times. The self-tensioning suture loop is formed of: (i) a simple metal surgical needle with a thin loop off the base of it to allow suture to slide through it; (ii) a single strand of surgical suture which can be of various sizes and colors; (iii) a large knot which is tied to create a large bulge to fix the construct to the device (this can be a knot or secondary piece of material, like a button); (iv) a splice formed by the single strand of suture going back through itself, the splice locking the suture in place; and (v) a suture tail that is pulled to reduce the loop size of the construct and tension the repair.