Looped Suture Construct for Soft Tissue Fixation
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Solution Overview
Problem
Surgical repairs of soft tissue to bone often fail due to 'suture pull-through' at the tissue-suture interface, particularly when sutures are under significant tension and engage the tissue for a short length, leading to detachment from the bone and inadequate healing.
Innovation Solution
The use of a looped suture construct where a suture is passed through the tissue to form a loop that grasps a larger surface area, with one end slidably connected through a suture anchor, reducing the likelihood of pull-through by distributing tension more effectively across the tissue.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If a suture strand is used to draw soft tissue into contact with bone, then the soft tissue can be mechanically reattached to bone, but the suture strand may pull through the soft tissue causing repair failure
Solution Approach 1:
The suture is divided into multiple segments: a first suture portion that engages the soft tissue, a loop portion that provides additional engagement, and a second suture portion that extends to the bone. This segmentation allows each portion to contribute to the overall tissue-grasping strength while distributing the load to prevent pull-through at any single engagement point.
Solution Approach 2:
The loop portion is formed by folding back the first suture portion onto itself, creating a nested structure where the loop is embedded within the suture construct. This nested loop configuration increases the effective engagement area with the soft tissue without adding separate components, thereby enhancing tissue-grasping strength while maintaining a compact structure that reduces pull-through risk.
2Force
If significant tension is applied to the suture to draw soft tissue into contact with bone, then the soft tissue reattachment is achieved, but the likelihood of suture pull-through increases
Solution Approach 1:
The suture construct is segmented into multiple engagement points along its length, including the first suture portion, loop portion, and second suture portion. This segmentation distributes the applied tension across multiple locations rather than concentrating it at a single point, allowing significant overall tension to be applied while reducing the likelihood of pull-through at any individual engagement site.
Solution Approach 2:
The loop portion introduces a dimensional change by folding the suture back onto itself, creating a three-dimensional configuration that engages the soft tissue from multiple directions. This multi-directional engagement distributes the tensile force across a larger spatial footprint, reducing stress concentration and preventing pull-through even under significant tension.
3Ease of manufacture
If the suture strand engages the soft tissue for a short length, then the surgical procedure is simplified, but the tissue-grasping capability is reduced
Solution Approach 1:
The loop portion is formed by folding back the first suture portion, creating a nested structure that extends the effective engagement length without requiring separate sutures or complex procedures. This nested configuration increases the tissue-grasping capability by providing additional engagement points along the suture path while maintaining procedural simplicity through the use of a single suture strand.
Solution Approach 2:
The loop portion provides dynamic engagement capability, allowing the suture to adapt to the soft tissue geometry through the folded-back configuration. This dynamic structure enables the suture to engage tissue over a longer effective length while maintaining ease of insertion through the single-pass technique, balancing procedural simplicity with enhanced tissue-grasping strength.
Data Source
AI summary
A looped suture construct is formed by looping a suture on itself and slidably connecting the suture through an anchoring structure such that a looped end and a free end of the suture are on opposite sides of the slidable connection. The anchoring structure may be bone, a suture anchor, or another structure securely attached to bone. The looped end and the free end are passed through the soft tissue to be repaired. The free end is then passed through the looped end. Tension is applied to the free end to draw the soft tissue into contact with the desired bone, whereupon the free end is secured to maintain the tension. The looped suture end remains open and positioned on one side or surface of the soft tissue. Suture anchors of the invention are pre-loaded with at least one suture having a looped end and at least one free end.