Suture-Button Graft Assembly for Short Bone-Tendon-Bone Grafts
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Solution Overview
Problem
Existing methods for attaching a bone-tendon-bone graft to a suture-button construct during ACL surgery are inefficient, as the graft is not long enough to be draped over the loop, limiting the use of button/loop constructs.
Innovation Solution
A method and assembly for constructing a button, suture, and tendon graft combination using a tendon graft, a holder, and a construct with a shuttle assembly to engage the suture assembly to the graft, allowing the graft to be suspended from the button, and a shuttle to pull the suture through a lumen, forming traps to prevent loop expansion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If a bone-tendon-bone graft is used, then the graft provides strong fixation capability, but the graft is not long enough to be draped over the loop end
Solution Approach 1:
The suture assembly is segmented into multiple components including a needle portion, a loop portion, and a free end, allowing the suture to be threaded through the graft and button in a structured manner that overcomes the length limitation
Solution Approach 2:
The suture loop is nested through the button aperture and the graft is positioned within the loop structure, creating a nested configuration where the limited-length graft is effectively utilized within the button-loop-graft assembly
2Ease of manufacture
If a button/loop construct is used with hamstring graft, then the construct can be purchased as a unit with graft draped over and trussed, but this method cannot be applied to bone-tendon-bone grafts
Solution Approach 1:
The button construct is designed with universal adaptability to work with different graft types including both hamstring grafts and bone-tendon-bone grafts, achieving multi-functionality across different surgical applications
Solution Approach 2:
The suture assembly is pre-configured with the needle, loop, and free end arranged in a specific configuration that allows immediate use during surgery, eliminating the need for complex intraoperative assembly while maintaining compatibility with bone-tendon-bone grafts
3Reliability
If the suture assembly is engaged to the graft and pulled through the lumen, then secure attachment is achieved, but the loop may expand post-implantation without traps
Solution Approach 1:
Traps are formed in the suture loop during assembly to preemptively counteract the expansion force that would occur post-implantation, applying preliminary anti-action to maintain loop shape stability
Solution Approach 2:
The suture loop is configured with dynamic traps that allow controlled movement and tension distribution, enabling the loop to maintain its shape while accommodating physiological movements without expanding
Data Source
AI summary
A method of constructing a button, suture, and tendon graft combination, utilizing a tendon graft, a holder and a construct engaged to the holder. The construct has an oblong button defining at least a first aperture and a second aperture; a suture assembly, engaged to the button and defining a lumen; and a shuttle assembly, having a loop end in the form of a shuttle loop, and a free end, and passing through the lumen between the loop end and the free end. In the method, the suture assembly is engaged to the tendon graft and the shuttle is used to pull a portion of the suture assembly through the lumen. Finally, the construct is disengaged from the holder.