Knotless Toggle Micro-Suture Anchors for Stable Rotator Cuff Repair
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Solution Overview
Problem
Existing arthroscopic methods for attaching soft tissue to bone, such as in rotator cuff repair, suffer from high failure rates, significant variation in outcomes, and prolonged recovery times, particularly for large or massive tendon tears.
Innovation Solution
A high-density array of knotless micro-suture anchors is used, implanted through the tendon (transtendinous) with a delivery system, providing a robust anatomical repair by closely approximating the natural tendon-bone relationship, utilizing a toggle mechanism for secure fixation and independent suture locking to minimize micromotion and enhance healing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional suture anchors with knots are used for rotator cuff repair, then the tendon can be attached to bone, but the repair has high failure rates (20-40%) and significant variation in outcomes
Solution Approach 1:
The suture anchor is divided into separate functional components: a toggle body for bone engagement, fins for anchoring, and a suture passage system. This segmentation allows each component to be optimized independently, improving reliability while managing complexity through modular design
Solution Approach 2:
The toggle mechanism acts as an intermediary between the suture and bone, providing a mechanical advantage that distributes load more effectively. The toggle body translates suture tension into radial forces that secure the anchor in the bone tunnel, reducing failure rates
2Reliability
If open surgical technique with large incision is used, then rotator cuff repair can be completed with high success rate, but deltoid dysfunction and extensive rehabilitation time occur
Solution Approach 1:
The invention replaces the mechanical trauma of open surgery with a minimally invasive arthroscopic delivery system. The toggle anchor mechanism provides equivalent or superior fixation strength while avoiding deltoid splitting, reducing rehabilitation time by at least 50%
Solution Approach 2:
The toggle anchor system is designed to work through standard arthroscopic portals, making it universally applicable to various rotator cuff tear sizes and configurations without requiring open surgical exposure, thus maintaining high success rates while reducing recovery time
3Ease of operation
If all-arthroscopic techniques are used for rotator cuff repair, then trauma and recovery time are reduced, but the procedure is difficult to perform with high variation in outcomes (4-90% failure rate)
Solution Approach 1:
The toggle anchor is designed to self-settle and self-lock within the bone tunnel through its own geometry and the applied suture tension. The fins automatically engage with the bone wall as the toggle is drawn through, reducing the skill dependency and variability associated with manual anchoring techniques
Solution Approach 2:
The invention changes the critical parameters of arthroscopic repair by using a toggle mechanism with specific geometric parameters (fin angle, toggle body dimensions) that optimize bone engagement. This standardization of key parameters reduces surgical variability and improves reliability across different surgeons and institutions
4Strength
If large or massive tendon tears are repaired, then complete restoration of function is attempted, but failure rates increase significantly compared to smaller tears
Solution Approach 1:
The toggle anchor is pre-loaded with suture material and designed to be deployed in a specific sequence, creating preliminary tension and approximation of the tendon to bone before final fixation. This preliminary action ensures proper alignment and distributes load across the repair site, improving outcomes for large and massive tears
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
The system reduces failure rates to less than 10%, allows for faster recovery, and minimizes tendon slippage during joint movement, enabling early physical therapy and reducing rehabilitation time by at least 50%.
Implementation Method 1
utilizing a toggle mechanism for secure fixation
Implementation Method 2
The anchor may include fins that extend beyond a circumference of the anchor body
Data Source
Figure 1A~1C
Figure 1D~1E
Figure 1F~1G
AI summary
A toggle-type suture anchor for transtendinous implantation in bone to secure soft tissue thereto during repair of a tear, especially a rotator cuff repair. The anchor can include an elongate body with side surfaces defining a maximum diameter of the body. The body can also include proximal, middle and distal bores extending from the top surface to the bottom surface, each bore located at spaced intervals along the elongate body with a single suture passing into the proximal bore top surface and out the bottom surface, then back up through the distal bore bottom surface out the top surface leaving a length of suture extending past the middle bore bottom surface. To assure toggling in transtendinous delivery into bone, the elongate body can include a pair of fins extending both proximally and radially outward from the elongate body to prevent back out once placed in a bone hole.