Tibial Prosthesis Fixation With Porous Modular Tissue-Ingrowth Inserts
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Solution Overview
Problem
Existing joint replacement surgeries face challenges in securely attaching soft tissue, such as ligaments and tendons, to prosthetic components due to the risk of single suture or wire failure under joint movement, especially in revision surgeries or procedures involving significant bone removal.
Innovation Solution
The use of a filamentary attachment structure, including a baseplate, stem, and keel, with a filamentary receiving component that facilitates soft tissue connection and ingrowth, utilizing materials like synthetic polymers, bioresorbable fibers, ceramics, and biological materials to secure soft tissue to the prosthesis.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Device complexity
If a single suture or wire is used to attach soft tissue to the prosthesis, then the device complexity is reduced, but the reliability of the connection deteriorates due to the risk of failure under joint movement forces
Solution Approach 1:
The attachment structure is divided into multiple independent sutures or wires (typically 2-4 strands) that are threaded through the prosthesis and soft tissue. Each strand acts as an independent load-bearing element, so that if one fails, the others maintain the connection. This segmentation transforms a single-point-failure system into a redundant multi-point system, significantly improving reliability while adding only moderate complexity.
Solution Approach 2:
The design incorporates redundant sutures or wires that serve as a safety backup before actual failure occurs. The multiple strands are configured to share the load, creating a buffer against the high forces generated during joint movement. This prior cushioning approach ensures that even under extreme loading conditions, the connection remains reliable as long as at least one strand remains intact.
2Reliability
If multiple sutures or wires are used to improve connection reliability, then the reliability improves, but the device complexity and ease of operation worsen due to threading and maintenance requirements
Solution Approach 1:
Multiple sutures or wires are combined into a single integrated attachment mechanism that is threaded through the prosthesis body in a predetermined pattern. The strands are configured to emerge at convenient locations for soft tissue attachment, and they can be tied or secured using standardized surgical techniques. This merging approach allows the complexity of multiple elements to be managed through a unified installation procedure, reducing the operational burden despite the increased number of components.
3Strength
If a solid prosthesis structure with openings is used, then the manufacturing precision and strength are improved, but the ease of manufacture and device complexity worsen due to the need for precise openings and suture threading paths
Solution Approach 1:
The sutures or wires are pre-threaded through the prosthesis during manufacturing, with the strands exiting at predetermined locations that correspond to the intended soft tissue attachment sites. The prosthesis is designed with pre-formed channels or pathways that guide the sutures through the body, ensuring proper positioning and tension distribution. This preliminary action eliminates the need for complex intraoperative threading procedures and reduces the skill level required for implantation, while maintaining the structural integrity and strength of the solid prosthesis body.
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
Provides a strong, long-term connection of soft tissue to orthopedic assemblies by allowing tissue ingrowth, reducing the risk of connection failure and enhancing the stability of soft tissue attachment to joint prostheses.
Implementation Method 1
a filamentary receiving component that includes a first portion and a second portion... facilitates tissue ingrowth therein to facilitate a strong long-term connection
Data Source
AI summary
An orthopedic assembly includes a tibial prosthesis that includes a body that defines an anterior side and a posterior side. The body further incudes a recess in the anterior side of the joint prosthesis and a plurality of openings that extend through the body from the anterior side to the posterior side thereof. At least a first and second opening of the openings are positioned at respective lateral and medial sides of a longitudinal axis of the tibial prosthesis. A modular insert is positioned within the recess of the body such that at least a portion of the modular insert is positioned between the openings of the body. The modular insert is formed separately from the tibial prosthesis and has a porous outer surface to promote tissue ingrowth.