Soft Tissue to Bone Attachment with Independent Suture Tensioning
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Solution Overview
Problem
Current methods for reattaching soft tissue to bone, such as the medial meniscus, lack effectiveness in providing controlled and reproducible attachment, often relying on single sutures or dependent suture systems that fail if one suture fails, leading to inadequate joint mechanics and potential arthritis progression.
Innovation Solution
The method involves creating two parallel tunnels in a bone with controlled distance and radial positioning, using instruments with marked shafts and drill guides to independently tension multiple sutures at different orientations, ensuring secure attachment of soft tissue to bone without reliance on a single suture's integrity.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If multiple sutures are used to attach soft tissue to bone, then the reliability of attachment is improved, but the device complexity increases
Solution Approach 1:
The attachment system is segmented into multiple independent suture constructs (e.g., 2-4 separate sutures) rather than using a single suture. Each suture is passed through separate bone tunnels and can be tensioned independently, allowing the system to maintain reliability through redundancy while managing complexity through modular design
Solution Approach 2:
The patent implements redundancy by using multiple independent sutures where failure of one suture does not compromise the entire attachment. This 'cushioning' against failure is built into the system design from the outset, where each suture acts as an independent safety backup, ensuring that partial failure does not lead to complete attachment failure
2Ease of operation
If multiple bone tunnels are created for suture passage, then the control over soft tissue positioning is improved, but the manufacturing precision requirements increase
Solution Approach 1:
Bone tunnels are created at predetermined locations and orientations before suture passage and tissue attachment. The tunnels are pre-positioned to establish the geometric framework for controlled soft tissue placement, allowing subsequent sutures to be routed through fixed pathways that guarantee proper tissue positioning when tensioned
Solution Approach 2:
The patent employs nested guiding structures where outer tunnel guides or aiming devices provide the framework for creating inner tunnels. This nesting approach allows precise tunnel placement by using the previously created tunnel or guide as a reference for subsequent tunnel creation, thereby managing precision requirements through hierarchical guidance
3Adaptability or versatility
If independent suture tensioning is implemented, then the adaptability of the attachment system is improved, but the ease of operation decreases
Solution Approach 1:
The attachment system transitions from static, fixed-tension sutures to dynamic, independently adjustable sutures. Each suture can be tensioned to different degrees based on the specific anatomical requirements and tissue positioning needs, allowing the system to adapt to varying clinical scenarios while providing controlled adjustability during the surgical procedure
Data Source
AI summary
Embodiments of the invention include implants, instruments, and methods for attaching or reattaching soft tissue (200, 2200) to a bone (100), that enable independent tensioning of multiple connectors such as sutures (60, 160, 2060, 2160) and enable redundant fixation between bone (100) and soft tissue (200, 2200). Some embodiments provide for improved accuracy of the placement of substantially parallel tunnels through which soft tissue (200, 2200) to bone (100) connectors such as sutures (60, 160, 2060, 2160) are passed.