Less Invasive Shoulder Arthroplasty via Rotator Interval Access
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Conventional shoulder replacement procedures require large incisions and muscle detachment, leading to invasive approaches that can cause trauma and limit the preservation of anatomical structures like the subscapularis and supraspinatus muscles.
Innovation Solution
A method for performing arthroplasty on the glenohumeral joint involving a less invasive technique, where an incision is made superior and lateral to the joint, allowing for the insertion of an implant with a stem oriented parallel to the humerus' longitudinal axis, while maintaining the subscapularis and supraspinatus muscles intact, and using prosthetic stems and humeral heads with adjustable coupling mechanisms to restore anatomical motion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If conventional shoulder replacement procedures are performed with large incisions and muscle detachment, then access to the glenohumeral joint is achieved, but tissue trauma increases and anatomical structures are damaged
Solution Approach 1:
The patent changes the surgical approach from a lateral/deltoid-based incision to a superior incision approach. This dimensional change in incision location allows access to the glenohumeral joint through the rotator interval without requiring detachment of the subscapularis or supraspinatus muscles, thereby reducing tissue trauma while maintaining surgical accessibility
Solution Approach 2:
The surgical approach is segmented into specific anatomical zones: the incision is placed in the superior deltoid region, the passage is formed through the rotator interval between the supraspinatus and infraspinatus muscles, and the subscapularis muscle is preserved as a distinct intact structure. This segmentation allows selective access to the joint while preserving critical muscle attachments
2Ease of operation
If conventional procedures cut muscle and muscle attachments for access, then the glenohumeral joint can be accessed, but the integrity of the rotator cuff is compromised
Solution Approach 1:
The patent utilizes the rotator interval as a natural anatomical passage that provides access to the glenohumeral joint without compromising rotator cuff integrity. By approaching through this superior interval rather than through muscle detachments, the surgical path preserves the structural continuity of the subscapularis and supraspinatus muscles
Solution Approach 2:
The rotator interval serves as an intermediary passage that mediates access to the glenohumeral joint. This natural anatomical space between the supraspinatus and infraspinatus muscles acts as a conduit, allowing surgical instruments to reach the joint while the surrounding rotator cuff muscles remain intact and functional
3Ease of operation
If large incisions are made for shoulder replacement, then adequate exposure is achieved, but the invasiveness of the procedure increases
Solution Approach 1:
The patent employs a superior incision approach rather than a traditional lateral incision, changing the spatial dimension of the surgical access. This superior approach through the rotator interval provides adequate joint exposure with a smaller, more localized incision, thereby reducing procedural invasiveness while maintaining surgical visibility and access
Data Source
AI summary
A method for performing an arthroplasty on at least one of a glenoid or a humerus of a glenohumeral joint. The method includes the following: forming an entry incision in soft tissue superior and lateral to the glenohumeral joint; forming a passage from the entry incision to the glenohumeral joint; inserting a cutting instrument through the passage and cutting a humeral head of the humerus to prepare the humerus to receive an implant including a stem; inserting the implant through the passage; and securing the implant relative to the humerus with the implant oriented such that the stem extends substantially parallel to a longitudinal axis of the humerus.