Arthroscopic Rotator Cuff Repair Trough and Tensioning Device
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Solution Overview
Problem
Current rotator cuff repair techniques, especially arthroscopic methods, lack the biological healing associated with traditional open repairs, leading to higher failure rates due to technical complexity and inadequate tendon-to-bone fixation.
Innovation Solution
An arthroscopic method involving the creation of a trough in the humeral head and the use of an adjustable tensioning and securing device to securely attach the rotator cuff tendon, utilizing a surgical burr and a combination awl and suture retriever deployment device to facilitate sutures through tunnels, ensuring proper tension and fixation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional open repair with large incision and deltoid splitting is used, then excellent functional results and biological fixation are achieved, but long recovery time and deltoid trauma occur
Solution Approach 1:
The procedure is divided into distinct phases: arthroscopic preparation and trough creation, followed by mini-open incision for tendon fixation. This segmentation allows the least invasive method to be used for diagnostic and preparatory steps, while the more invasive open approach is limited to the specific task of tendon-to-bone fixation, minimizing overall tissue trauma.
Solution Approach 2:
The incision and soft tissue dissection are localized to a small mini-open approach rather than a large deltoid split. The arthroscopic ports provide localized access for visualization and tool insertion, concentrating the invasive elements to minimal necessary areas while preserving surrounding tissue integrity.
2Object-affected harmful factors
If mini-open approach with arthroscopic inspection and open fixation is used, then less invasive than traditional open repair is achieved, but inferior biological healing compared to open trough repair occurs
Solution Approach 1:
The procedure merges arthroscopic techniques (for inspection, debridement, and trough creation) with mini-open fixation (for tendon attachment). This combination allows the biological benefits of open trough repair to be achieved while using arthroscopy to minimize soft tissue disruption and enhance visualization of the repair site.
Solution Approach 2:
The arthroscopic trough is created in advance through the mini-open approach, preparing the bone surface and establishing the fixation site before the tendon is sutured and attached. This preliminary preparation ensures optimal conditions for biological healing are established prior to tendon fixation.
3Object-affected harmful factors
If purely arthroscopic repair with suture anchors is used, then minimal tissue trauma is achieved, but technical complexity increases and biological healing is lacking
Solution Approach 1:
The procedure segments the complexity by dividing it into arthroscopic components (inspection, debridement, trough creation) and a simplified open component (tendon fixation). This segmentation reduces the overall technical complexity compared to purely arthroscopic anchor fixation while maintaining minimal tissue trauma benefits.
4Object-affected harmful factors
If purely arthroscopic repair with suture anchors is used, then minimal tissue trauma is achieved, but inadequate tendon-to-bone fixation and higher failure rates occur
Solution Approach 1:
The fixation method is optimized for the specific local requirement of tendon-to-bone attachment by using direct suture anchoring to the humeral head through a small incision. This localized open fixation provides superior mechanical strength and biological healing at the critical attachment site while maintaining minimal overall tissue disruption through arthroscopic assistance.
Data Source
AI summary
An arthroscopic method for reattaching a rotator cuff tendon to a humeral head may include creating a trough in the top of the humeral head, creating a cavity in the lateral portion of the humeral head, creating one or more tunnels between the cavity and the trough, retrieving sutures affixed to a loose end of the tendon through the trough, at least one tunnel, and the cavity; and passing the sutures through a tensioning and securing device, which is then implanted in the cavity, and the sutures are variously pulled or released to pull, tension, or release the sutures until the tendon is secured in the trough. The trough is preferably created using a unique extendable, angled surgical burr.