Offset Drill Guide for Bankart Repair
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Solution Overview
Problem
Arthroscopic Bankart repair procedures face challenges in accurately guiding suture anchors into the glenoid rim due to obscured visualization and limited bone structure, leading to potential bone fracture and unsatisfactory implant placement.
Innovation Solution
A cannulated offset drill guide with a concave clear tip, offset from the guide center line by 1 to 3 mm, allows precise alignment and minimal bone removal, enabling secure placement of suture anchors on the glenoid face with reduced risk of damage.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If a conventional drill guide is used for arthroscopic Bankart repair, then the procedure can be performed, but accurate positioning of suture anchors is difficult due to obscured visualization of the glenoid anatomy
Solution Approach 1:
The patent introduces a drill guide as an intermediary tool that mediates between the surgeon's external manipulation and the internal glenoid anatomy. The drill guide provides reference markings and alignment features that translate external visualization into accurate internal positioning, overcoming the obscuration caused by deltoid muscle and tendons.
Solution Approach 2:
The drill guide incorporates visual indicators and markings that provide clear visual feedback to the surgeon during positioning. These visual cues enable accurate alignment and positioning of the drill guide relative to the glenoid face, compensating for the limited visualization of underlying anatomy.
2Strength
If the drill is inserted deeply into the glenoid to secure the suture anchor, then the anchor is firmly fixed, but there is a risk of bone fracture or damage to soft tissue
Solution Approach 1:
The drill guide is positioned and aligned before drilling begins, establishing predetermined safe drilling parameters. The guide provides depth markers and alignment references that prevent excessive drilling depth, allowing the surgeon to achieve adequate fixation strength without penetrating into critical zones that could cause bone fracture or soft tissue damage.
Solution Approach 2:
The drill guide acts as an intermediary control mechanism that mediates between the drilling action and the glenoid bone. It provides physical constraints and visual feedback to limit drilling depth and maintain proper trajectory, preventing harmful over-penetration while still achieving sufficient anchor fixation.
3Adaptability or versatility
If the suture anchor is placed on the narrow articulating surface of the glenoid, then the labrum can be reattached, but the labrum tends to pull off due to the narrow and vertical surface
Solution Approach 1:
The drill guide enables precise localization of the optimal anchor placement site on the glenoid face. By providing alignment markings and reference features, the guide allows the surgeon to position the anchor at a specific location with favorable bone geometry and orientation, creating a localized secure attachment point that can withstand labral pulling forces.
Solution Approach 2:
The drill guide transforms the limited two-dimensional narrow articulating surface into a more favorable three-dimensional anchoring geometry. By controlling the drill trajectory and angle through the guide, the surgeon can create an inclined or optimized bore path that engages more robust bone structure, effectively adding a dimensional component to the anchor placement that enhances stability.
4Ease of manufacture
If extensive bone removal is performed to accommodate the suture anchor, then the anchor can be securely placed, but the structural integrity of the glenoid is compromised
Solution Approach 1:
The drill guide enables partial action by providing precise control over the drilling process. The guide markers indicate the exact depth and extent of bone removal needed, allowing the surgeon to remove only the minimal necessary amount of bone to accommodate the anchor, rather than performing extensive bone resection. This preserves glenoid structural integrity while still achieving secure anchor placement.
Data Source
AI summary
A cannulated offset drill guide and surgical methods for repairing Bankart lesions. The cannulated offset drill guide comprising a shaft which is offset from the guide center line by about 1 to 3 mm, more preferably of about 1.5 mm. The cannulated offset drill guide is provided at its proximal end with a concave clear tip which allows a surgeon to visualize the drill and the insertion of an anchoring device, for example a suture anchor. The concave clear tip has beveled, smooth edges to prevent damage to adjacent bone and tissue, and to avoid damage to the rubber dam of the cannula through which the offset drill guide is inserted. The configuration of the concave clear tip is designed to engage and match the generally convex-curve articulating face of the glenoid, and to precisely aligning the offset drill guide with the glenoid face. The clear tip may also be employed in a standard drill guide having a shaft which is not offset from the center line of the guide.