Scapular Tether for Dynamic Shoulder Stabilization
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Solution Overview
Problem
Current shoulder repair methods, including surgical reconstruction and device reattachment techniques, often fail to provide long-term stability and function due to recurring issues with scapular dyskinesis, bone deficiencies, and rotator cuff tears, leading to persistent pain and reduced arm function.
Innovation Solution
A surgical system comprising an elongate flexible implant that attaches to the rib and scapula, changing length in response to scapular movement to control and stabilize the scapula's motion, thereby addressing scapular dyskinesis and promoting normal arm function without the need for external wearables.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If surgical reconstruction targeting soft tissues (labral repairs) is performed, then certain shoulder instability problems are addressed, but cases with significant bone deficiency (greater than 20% of glenoid surface area missing) are not sufficiently treated
Solution Approach 1:
The suture anchor system provides dynamic adjustment capability, allowing the surgeon to adjust the tension and positioning of the suture as it passes through the bone tunnel and attaches to the labrum. This dynamic adjustment enables the same system to adapt to varying degrees of bone deficiency and different patient anatomies, making soft tissue repair applicable to cases with significant bone deficiency.
Solution Approach 2:
The invention changes key parameters of the repair system by using a bone tunnel approach that allows variable positioning and angulation of the suture anchor. The bone tunnel can be created at different orientations and locations depending on the extent of bone deficiency, and the suture anchor can be positioned at varying depths and angles to optimize repair for each specific case, thereby extending applicability to severe bone deficiency cases.
2Manufacturing precision
If bone graft is used to reconstruct significant bone deficiencies, then bone defects can be addressed, but proper alignment with the glenoid or other bone structure is challenging
Solution Approach 1:
The bone tunnel acts as an intermediary structure that facilitates precise alignment between the suture anchor and the glenoid bone. By creating a controlled tunnel through the bone at a predetermined angle and location, the system provides a guided pathway that ensures proper alignment of the suture with the bone structure, eliminating the alignment challenges associated with direct graft attachment.
Solution Approach 2:
The bone tunnel is created preliminarily before inserting the suture anchor and attaching the labrum. This preliminary action establishes the correct alignment and positioning in advance, allowing subsequent steps to proceed with precise geometric relationships already in place. The tunnel serves as a pre-established guide that simplifies the attachment procedure and ensures proper alignment.
3Ease of operation
If currently available devices (screws, staples, suture anchors, tacks) are used to reattach the rotator cuff, then reattachment can be achieved, but complete healing or prevention of recurrence is not guaranteed as the patient moves the shoulder
Solution Approach 1:
The suture anchor system applies continuous counter-tension to the torn rotator cuff tendon as the patient moves the shoulder. The suture is tensioned through the bone tunnel and anchored securely, creating a counterbalancing force that opposes the tensile loads placed on the repair during shoulder motion. This continuous counter-tension helps maintain proper alignment and reduces stress on the healing interface, improving healing durability.
Solution Approach 2:
The invention provides continuous stabilization and support to the reattached rotator cuff throughout the range of motion. The suture anchor system remains actively engaged during patient movement, continuously monitoring and adjusting tension to maintain optimal repair conditions. This continuous useful action prevents the loss of alignment that occurs with passive fixation devices, ensuring durable healing during daily activities.
4Reliability
If surgery is performed to reduce scapular dyskinesis, then initial effectiveness can be achieved, but scapular dyskinesis recurs after surgery as the patient moves the shoulder
Solution Approach 1:
The suture anchor system provides dynamic stabilization of the scapula during patient movement. As the patient moves the shoulder through daily ranges of motion, the suture maintains appropriate tension and positioning, allowing the scapula to move naturally while preventing dyskinesis. This dynamic adaptation enables reliable scapular position control that persists during active motion rather than failing as with static fixation methods.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The flexible implant effectively treats scapular dyskinesis and prevents rotator cuff tears by ensuring proper scapular motion, reducing pain and improving arm function with a minimally invasive, internal solution that does not require external support.
Implementation Method 1
The flexible implant effectively treats scapular dyskinesis and prevents rotator cuff tears by ensuring proper scapular motion, reducing pain and improving arm function with a minimally invasive, internal solution that does not require external support.
Implementation Method 2
The cam is configured to move with a person's scapula, and control a change in force applied to the scapula by the tether as the tether changes in length.
Data Source
AI summary
In general, scapular tethers and methods of using scapular tethers are provided. A tether is configured to be implanted in a body of a patient and to control movement of the patient's scapula. In an exemplary embodiment, the tether is configured to be attached to at least one body structure in a patient. The tether includes a flexible member configured to, when implanted in the patient, flex in response to movement of the patient's scapula accompanying arm movement of the patient.