Whipstitched Graft Construct for Stable Ligament Fixation
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Solution Overview
Problem
Current methods for attaching a substitute ligament or tendon to bone during surgery lack efficient tensioning mechanisms, making it difficult to achieve stable and secure attachment, which is crucial for effective healing and regrowth.
Innovation Solution
A whip stitched graft construct is employed, utilizing a suture loop construct with a free floating needle to securely attach and tension tendon strands, providing increased pull-out strength and allowing for accelerated healing by forming a construct with both stitched and unstitched regions, facilitating easier graft fixation and adjustment.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a substitute ligament or graft is attached to bone using conventional methods, then the graft can be secured in the tunnel, but achieving proper tension and stability is difficult and time-consuming
Solution Approach 1:
The whipstitch sutures are pre-configured and pre-tensioned on the graft before insertion into the bone tunnel. This preliminary action ensures that the graft is already properly tensioned and stable upon insertion, eliminating the need for time-consuming tensioning adjustments after fixation.
Solution Approach 2:
The graft is divided into multiple segments or strands that are individually whipstitched and tensioned. This segmentation allows each strand to be independently secured and tensioned, improving overall graft stability while reducing the complexity of tensioning the entire graft at once.
2Manufacturing precision
If the graft is tensioned after partial insertion into the tibial tunnel, then proper tension can be achieved, but the process becomes cumbersome and difficult
Solution Approach 1:
The whipstitch sutures are configured and tensioned on the graft before insertion, so the tensioning action is completed beforehand. This eliminates the need for difficult post-insertion tensioning adjustments, making the operation easier while maintaining precise tension control.
Solution Approach 2:
The whipstitch suture construct acts as an intermediary mechanism that transfers and maintains tension on the graft. The sutures are threaded through the graft in a specific pattern that allows tension to be distributed and maintained uniformly, simplifying the tensioning process.
3Strength
If multiple suture passes are used to stitch tendon strands together, then pull-out strength is increased, but the stitching process becomes more complex
Solution Approach 1:
Multiple suture passes are combined into a single continuous whipstitch pattern that weaves through the tendon strands. This merging of multiple stitching actions into one continuous process increases pull-out strength while reducing the complexity of performing multiple separate stitching operations.
Solution Approach 2:
The whipstitch suture follows a curved, spiral path through the tendon strands rather than straight linear passes. This curved stitching pattern distributes tension more evenly and increases pull-out strength by engaging more of the tendon cross-section, while the continuous curved path is easier to execute than multiple straight passes.
Data Source
AI summary
A whip stitched graft construct and method of formation. The whip stitched graft construct includes a plurality of tendon strand regions or soft tissue grafts placed together so that at least a portion of the plurality of the tendon strand regions are stitched together by employing multiple suture passes placed according to a whip stitching technique. Preferably, the multiple suture passes start at about the mid length of the plurality of tendon strand regions and are advanced toward one of the free ends of the tendon strands. The whip stitched graft construct is provided with at least two regions, one region formed of at least a plurality of tendon strand regions tied and whip stitched together, and the other region formed of untied segments of the plurality of tendon strands.