Single Tunnel Double Bundle ACL Reconstruction System
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Solution Overview
Problem
Current ACL reconstruction techniques face challenges such as increased surgical time and complexity, difficult revision, notch impingement, and PCL impingement due to the double tunnel, double bundle method, which also lacks osteoconductivity for bony ingrowth and circumferential healing.
Innovation Solution
A novel single tunnel, double bundle ACL reconstruction system that combines cortical and aperture fixation, anatomically orienting graft bundles within a single tunnel to replicate the native ACL footprint, and includes a porous implant for osteoconductive healing, allowing for therapeutic agent delivery to enhance tendon-to-bone integration.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If double tunnel, double bundle method is used, then ACL reconstruction is achieved, but surgical time and complexity increase
Solution Approach 1:
The patent merges two separate bone tunnels into a single bone tunnel while maintaining double bundle graft configuration. The single tunnel is positioned to accommodate both anteromedial and posterolateral bundle grafts, reducing surgical complexity and operative time while achieving effective ACL reconstruction.
Solution Approach 2:
The graft is divided into two separate bundles within the single tunnel, with each bundle independently tensioned and fixed. This segmentation allows replication of native ACL functional bundles while using a simplified single tunnel approach.
2Reliability
If double tunnel, double bundle method is used, then ACL reconstruction is achieved, but revision becomes difficult
Solution Approach 1:
By using a single bone tunnel instead of two, the patent simplifies potential revision procedures. The single tunnel approach reduces bone stock consumption and makes subsequent tunnel placement easier compared to creating two separate tunnels, while still achieving double bundle reconstruction.
3Reliability
If double tunnel method is used, then ACL reconstruction is achieved, but notch impingement occurs
Solution Approach 1:
The single tunnel is positioned and sized to accommodate both bundles while maintaining adequate clearance from the intercondylar roof. By consolidating the tunnels, the patent reduces the total graft bulk in the notch region, eliminating impingement issues associated with two separate tunnels.
4Reliability
If double tunnel method is used, then ACL reconstruction is achieved, but PCL impingement occurs
Solution Approach 1:
The single tunnel trajectory is carefully planned to pass anterior to the posterior cruciate ligament, ensuring both bundles clear the PCL. This consolidated approach simplifies PCL avoidance compared to navigating two separate tunnels near the PCL.
5Strength
If conventional fixation is used, then graft fixation is achieved, but osteoconductivity for bony ingrowth is lacking
Solution Approach 1:
The patent employs a porous coating or porous implant material at the tunnel-graft interface to promote osteoconduction. The porous structure allows bone ingrowth into the fixation device, creating a biological bond that enhances long-term fixation reliability beyond mechanical fixation alone.
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
This approach reduces surgical complexity, facilitates easier revision, prevents notch and PCL impingement, and promotes long-term stability through osteoconductive healing and bone ingrowth, improving knee kinematics and functional outcomes.
Implementation Method 1
includes a porous implant for osteoconductive healing
Implementation Method 2
allowing for therapeutic agent delivery to enhance tendon-to-bone integration
Data Source
AI summary
A system for single tunnel, double bundle anterior cruciate ligament reconstruction includes implant constructs and instruments. The implant constructs provide a combination of cortical fixation and bone tunnel aperture fixation. The implant constructs separate a graft into distinct bundles. The instruments are used to prepare shaped bone tunnels to receive the implant constructs and graft bundles. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on single femoral and tibial tunnels and a single strand of graft.