Reinforcing Insert for Bone Plug Suture Pull-Through
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Solution Overview
Problem
The quality of bone plugs used in tissue grafts, particularly in ACL reconstruction, can be compromised, leading to a high risk of suture pull-through due to concentrated pressure during implantation, as the suture contacts the bone plug over a small area.
Innovation Solution
The use of a reinforcing insert with a convex upper surface and concave lower surface, positioned within the bone plug through-hole, redistributes the load applied by the suture, increasing the contact area and reducing pressure on the bone plug, thereby preventing failure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If a narrow suture is used to pull the bone plug through the tunnel, then the implantation procedure is simple, but the suture applies significant pressure on the bone plug causing pull-through failure
Solution Approach 1:
A cortical button is introduced as an intermediary device between the suture and the bone plug. The suture is looped around the button, which then contacts the bone plug over a larger surface area. This mediator distributes the pulling forces across the bone plug surface rather than concentrating them at a single point, preventing suture pull-through while maintaining procedural simplicity.
Solution Approach 2:
The solution transitions from a one-dimensional point contact (narrow suture on bone plug) to a two-dimensional surface contact (cortical button against bone plug). By adding this dimensional element, the contact area increases significantly, distributing the load across a broader surface and reducing peak stresses that cause failure.
2Device complexity
If the suture contacts the bone plug over a small area, then the device structure is simple, but the pressure concentration leads to bone plug failure
Solution Approach 1:
The cortical button serves as a mediating structure that interfaces between the suture and bone plug. It maintains structural simplicity while fundamentally improving the strength interaction by distributing contact forces across a larger area, preventing localized stress concentrations that would compromise bone plug integrity.
Solution Approach 2:
The solution changes the contact area parameter from small (direct suture-bone contact) to large (button-bone contact). This parameter modification directly addresses the strength issue by reducing pressure concentration, while the button's simple geometric form keeps the overall device complexity low.
Data Source
AI summary
Devices and methods for reinforcing tissue grafts are described herein. In one embodiment, an implant is described that includes a proximal end portion having a through-hole formed therein, a distal end portion, and a reinforcing insert disposed in the through-hole. The insert includes a proximal face, a distal face opposed to the proximal face, a first upper surface extending between the proximal and distal faces and having a generally convex shape that abuts against at least a portion of a sidewall of the through-hole, and a second lower surface extending between the proximal and distal faces and having a generally concave shape. The second lower surface and portions of the sidewall of the through-hole not abutted by the first upper surface form a reinforced through-hole of the implant.