Suture Management Device for Adjustable Soft Tissue Graft Tensioning
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Solution Overview
Problem
Current devices for ligament tensioning in ACL reconstruction are cumbersome, require excessive physical exertion, and often necessitate additional assistance, as they involve manual application and maintenance of tension, and may not ensure even tension across graft strands, especially in procedures requiring bone surface modification and multiple drill holes.
Innovation Solution
An adjustable, standalone suture management and tensioning system that allows a single operator to apply repeatable and selectable tension to a soft tissue graft without manual pulling, using a suture tensioning spring and rotatable knob, with a force level indicator and stop to limit tension, facilitating easy installation of the final fixation implant with minimal steps and time.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Force
If manual tensioning devices are used to apply and maintain tensile force during graft fixation, then ligament pretension can be established, but the procedure becomes cumbersome and requires excessive physical exertion and additional assistance
Solution Approach 1:
The suture management device applies tension to the graft through a suture tensioning spring that automatically maintains predetermined tension without requiring the practitioner to manually apply and hold force. The device serves itself by using the spring mechanism to continuously apply tension during the fixation process, eliminating the need for human physical exertion to maintain graft pretension.
Solution Approach 2:
The invention replaces the manual mechanical system (practitioner's hand force) with an automated mechanical system (suture tensioning spring). The spring mechanism converts elastic potential energy into continuous tensile force on the graft, substituting human physical effort with a self-regulating mechanical force application system.
2Force
If current tensioning devices are used, then graft pretension can be applied, but time-consuming preparation steps and additional assistants are required
Solution Approach 1:
The suture management device is pre-loaded with a suture tensioning spring that has been pre-tensioned to predetermined values. This preliminary preparation of the spring mechanism eliminates the need for time-consuming intraoperative tensioning adjustments and reduces procedural steps, allowing the practitioner to simply attach the device and achieve immediate, pre-calibrated graft tension.
Solution Approach 2:
The invention changes the parameter of tension application from manual, variable force to predetermined, standardized tension levels achieved through the pre-loaded spring mechanism. This parameter standardization eliminates time-consuming manual adjustment steps and allows for rapid deployment of the tensioning system during surgery.
3Force
If external fixturing and bone surface modification are used to support tensioning, then stable tensioning can be achieved, but patient trauma increases and procedural complexity increases
Solution Approach 1:
The invention extracts and eliminates the need for external fixturing and bone surface modification by integrating the tensioning function directly into a device that attaches to the graft itself. The suture management device removes the harmful external fixturing elements from the procedure while maintaining stable tensioning through its spring-based mechanism that works with the graft structure.
4Manufacturing precision
If manual tensioning requiring even force distribution is used, then graft strand tension equality can be achieved, but the procedure requires additional assistance and physical exertion
Solution Approach 1:
The suture management device achieves even tension distribution across graft strands through its self-regulating spring mechanism that automatically equalizes force application. The device serves itself by using the mechanical properties of the spring to distribute tension uniformly without requiring the practitioner to manually balance forces or coordinate with additional assistants.
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
Enables efficient, even, and reproducible tensioning of soft tissue grafts with reduced patient trauma and operational time, eliminating the need for additional assistance, and simplifying the installation of fixation implants by minimizing obstructions and requiring only one drill hole.
Implementation Method 1
a suture tensioning spring... for retracting the length of suture to place soft tissue to which the suture is attached in tension
Data Source
AI summary
An adjustable, stand-alone tensioning system requires no additional fixturing, weights, or bone surface modification, and allows a single practitioner to provide an adjustable and repeatable tension to a soft tissue graft, and to install the final fixation implant. Its design facilitates introduction of the suture component of the graft into the tensioning process by simplifying retention of the suture. An even, regulated and reproducible tension is easily achieved without requiring the practitioner to manually pull on the suture strands to maintain graft tension.