Soft Suture Anchor Arrays for Tensioned Rotator Cuff Reattachment
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Solution Overview
Problem
Existing arthroscopic rotator cuff repair techniques suffer from high failure rates, varying success among surgeons, and prolonged recovery times due to the difficulty in securely reattaching tendons to bone, particularly in large or massive tears.
Innovation Solution
A high-density array of knotless, soft suture anchors is implanted through the tendon using a delivery device, allowing for anatomical repair by closely approximating the natural tendon-bone relationship, reducing micromotion, and utilizing a continuous set of independently tensioned and locked suture stitches to enhance stability and healing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of time
If all-arthroscopic techniques are used for rotator cuff repair, then recovery time is reduced and surgical trauma is minimized, but the procedure becomes quite difficult to perform with high failure rates ranging from 20% to 40%
Solution Approach 1:
The repair system is divided into multiple independent suture anchors (typically 3-5 anchors) distributed across the rotator cuff footprint. Each anchor independently secures the tendon, and the combined effect of multiple anchors provides both the minimally invasive arthroscopic approach and the reliability needed to reduce failure rates. The segmentation allows for anatomical distribution of fixation points while maintaining ease of arthroscopic implantation.
Solution Approach 2:
The suture anchors are pre-loaded with sutures in a specific configuration before implantation. The sutures are threaded through the tendon in advance, and the anchors are prepared in a compressed state for delivery. This preliminary preparation ensures that when the anchors are deployed arthroscopically, the tendon is immediately secured in the correct anatomical position without requiring complex intraoperative manipulation, thereby maintaining low failure rates while enabling minimally invasive surgery.
2Reliability
If a high-density array of suture anchors is used to securely reattach tendon, then repair reliability improves, but the complexity of the procedure and device increases
Solution Approach 1:
Each suture anchor in the array is designed as a universal component that performs multiple functions: it provides mechanical fixation to bone, holds the suture in a pre-configured state, and maintains tendon positioning. The anchors are identical or similar in design, allowing for standardized implantation technique across all anchors in the array. This universality simplifies the overall device complexity while enabling the use of multiple anchors to achieve high reliability.
Solution Approach 2:
The system utilizes anchors with specific physical parameters optimized for arthroscopic delivery and deployment. The anchors are designed with small dimensions, appropriate stiffness, and controlled expansion characteristics that allow them to be delivered through small arthroscopic portals and securely fixed in bone with minimal manipulation. By optimizing these parameters, the system achieves high-density anchor placement without proportionally increasing procedural complexity.
3Reliability
If anatomical repair with close approximation of tendon-bone relationship is achieved, then healing quality improves and micromotion is reduced, but the precision required for implantation increases
Solution Approach 1:
The suture anchors are designed to self-position and self-secure the tendon in the correct anatomical location upon deployment. The pre-configured sutures automatically approximate the tendon to the bone footprint when the anchors are expanded in the bone. This self-service mechanism eliminates the need for complex manual positioning techniques, reducing the precision burden on the surgeon while ensuring high-quality anatomical repair and minimal micromotion.
Solution Approach 2:
The system replaces complex mechanical manipulation techniques with a simpler deployment mechanism. Instead of requiring precise manual suturing and tendon positioning, the pre-loaded anchors use elastic expansion and suture tensioning forces to automatically achieve anatomical approximation. This mechanical substitution simplifies the implantation process while maintaining high precision in tendon-bone apposition, thereby improving healing quality without proportionally increasing implantation difficulty.
Data Source
AI summary
Soft suture anchors are disclosed that can be formed into a pre-strung array with a common working suture. Each anchor includes the common working suture and a soft anchor member that is expandable when implanted. This allows first locking an individual anchor into a bone hole followed by tensioning the suture and independently locking the suture at the anchor. A first anchor is implanted through the tendon and the suture is locked. A second anchor is implanted a selected close distance from the first anchor, the working suture is tensioned between the first and second anchors, and the working suture is locked at the second anchor to create a single suture tensioned and locked stitch between the first and second anchor. This process is repeated for each anchor in the array.