Pilot Hole Trocar for Bone Fastener Retention
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Solution Overview
Problem
Current treatments for partial thickness tears in the supraspinatus tendon, particularly those less than 50%, do not effectively repair or strengthen the tendon, leading to chronic pain, stiffness, and potential for further degeneration, requiring additional surgical procedures and rehabilitation with high failure rates.
Innovation Solution
An arthroscopic apparatus and method using a pilot hole forming trocar assembly with position retention sleeve and spike to create pilot holes in bone, allowing for the insertion and retention of fasteners to fix sheet-like materials or implants over damaged tendons, thereby providing a means to strengthen or repair the tendon without cutting the untorn portion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If current treatments are used for partial thickness tears less than 50%, then the tendon is left unrepaired, but this leads to chronic pain, stiffness, and potential for further degeneration
Solution Approach 1:
The patent applies preliminary action by creating pilot holes in the bone before inserting fasteners to secure the sheet-like material to the bone. This pre-preparation of the bone structure enables effective fixation that strengthens the tendon attachment site, preventing further degeneration and addressing the root cause of chronic pain and stiffness associated with unrepaired partial thickness tears
2Strength
If sheet-like materials are fixed to bone using traditional methods, then fixation may be achieved, but the tendon is not effectively strengthened or repaired
Solution Approach 1:
The patent applies segmentation by dividing the fixation function into multiple components: the sheet-like material provides tendon reinforcement, while separate fasteners secured through pilot holes provide stable bone attachment. This segmented approach ensures both tendon strengthening and reliable fixation, addressing the insufficiency of traditional single-method fixation that failed to effectively repair the tendon
3Device complexity
If no intervention is performed on partial thickness tears, then surgical procedures are avoided, but this results in high failure rates and need for additional surgeries
Solution Approach 1:
The patent applies parameter changes by modifying the bone structure through pilot hole creation, which changes the mechanical properties of the bone-tendon interface. This parameter modification enables reliable fastener fixation that secures the sheet-like material effectively, providing a successful treatment outcome that prevents the need for additional surgeries while maintaining manageable procedural complexity
Data Source
AI summary
Apparatus and methods for forming pilot holes in bone and deploying a staple therein for fixing a sheet-like implant to the bone. A pilot hole forming trocar assembly including a trocar and a position retention sleeve can be included. The trocar can be releasably coupled to the position retention sleeve and slide in keyed arrangement within the sleeve when uncoupled. The trocar can include a distal portion having a retractable blade and a pair of pilot hole forming spikes extending distally from the trocar shaft. Once the pilot holes are formed, the position retention sleeve maintains the position relative to the pilot holes while the trocar is removed and a staple delivery device can be inserted in the lumen of the position retention sleeve to deploy a staple in the pilot holes.