Suture-Button-Graft Construct with Pre-formed Traps
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current tendon replacement surgery methods, particularly for ACL replacement, lack a versatile and efficient method for constructing a suture-button-graft combination that can be used with both hamstring and patella-harvested bone-tendon-bone grafts, limiting surgical options and graft stability post-implantation.
Innovation Solution
A method and construct involving an oblong button with apertures, a suture length with braided lumen, and shuttles to create a secure loop around a tendon graft, allowing for pre-surgical assembly and secure fixation, preventing loop expansion post-implantation by using needles and shuttles to form traps and overlaps within the suture length.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If a button/loop construct is used with bone-tendon-bone graft, then surgical options are expanded, but the graft cannot be draped over the end of the loop like hamstring grafts requiring alternative fixation methods
Solution Approach 1:
The suture loop is pre-formed on the button construct before graft implantation. The sutures are threaded through the button apertures and prepared in advance, allowing the bone-tendon-bone graft to be attached to the pre-configured loop structure, eliminating the need for alternative fixation methods
Solution Approach 2:
The suture is threaded through the button apertures and nested within the button structure. The graft is then attached to this nested suture configuration, creating a integrated button-suture-graft assembly that works with bone-tendon-bone grafts
2Reliability
If a suture loop is created around the graft, then secure fixation is achieved, but the loop may expand post-implantation compromising stability
Solution Approach 1:
Traps are created in the suture loop during construction to preemptively prevent loop expansion after implantation. The traps are formed by threading the suture through itself in a way that creates mechanical resistance to expansion forces
Solution Approach 2:
The suture configuration is changed from a simple loop to one with integrated traps and overlaps. This parameter change in the suture geometry fundamentally alters the mechanical behavior of the loop, preventing expansion while maintaining secure graft fixation
3Reliability
If the graft is harvested from the patient's patella yielding bone-tendon-bone graft, then graft stability is improved, but the graft is not long enough to be draped over the end of the loop
Solution Approach 1:
The suture loop is pre-formed on the button construct before graft implantation. The sutures are threaded through the button apertures and prepared in advance, allowing the bone-tendon-bone graft to be attached to the pre-configured loop structure, eliminating the need for alternative fixation methods
Solution Approach 2:
The fixation system is segmented into distinct functional components: the button provides the anchor point, the suture creates the loop structure, and the graft provides the tendon replacement. This segmentation allows each component to be optimized independently, with the suture length and configuration tailored to accommodate shorter bone-tendon-bone grafts
Data Source
AI summary
A suture and button construct, having an oblong button defining at least a first aperture and a second aperture; a suture length, including a braid defining a lumen and having a middle section and two end sections, each extending through a button aperture and both terminating in an end. Both ends have a needle attached. Also, two shuttles are engaged to the suture length, each having a free end and a loop end, terminating in a loop. Each shuttle enters the lumen in the middle section and extend through an aperture, while in the lumen and exit on the opposite button side from the middle section, so that both shuttle loops are available outside the lumen, to pull a suture end through the lumen and a button aperture.