90% of cranial cruciate cases are treated with some form of lateral extra-capsular suture. Many of these cases go on to fail and result in osteoarthritis. Complications related to lateral extra-capsular repairs include: infection, bone erosion, suture failure, capsule thickening and rapid joint deterioration. Improvement of the implant is possible and has the potential to improve clinical outcomes.
The goal of the Ruby Joint Stabilization System* is to provide surgeons with the most biocompatible, strongest, abrasion resistant implant that is stable at its interface to the bone, straightforward in its surgical application and kinematically compatible with canine stifle range of movement.
The Ruby system is comprised of a bone anchor screw with a ruby eyelet at the suture exit and a grooved conical pin to affix a closed loop of suture to the anchor. Two anchors, preassembled with suture in set lengths, are inserted into the tibia and femur, leaving a small gap between the suture loops. The assembly is completed by hooking the loops together with a polished titanium link. The loops are trapped within the link by a snap-in PEEK link lock.
The Ruby system circumvents the need to tie knots or crimp, bringing the ultimate strength of the construct closer to the theoretical limit of the materials. Internal testing yielded static strength in excess of 1,000 N.
To address the infection, bone erosion, breakage and loosening complications related to bone tunneling, the Ruby system attaches the suture to the bone using a titanium aluminum niobium (TAN) bone anchor screw and mono-crystalline ceramic ruby eyelet. TAN is optimal for osseointegration and the ceramic ruby provides an ideal surface for the sweeping movement of the unbraided and uncoated ultra-high molecular weight polyethylene (UHMWPE) suture loops.
The KYON lateral suture project began in 2007 and underwent several design iterations and rounds of in vitro testing before the first clinical case in 2015. At this time, the Ruby system is in limited clinical release and meeting the expectations of the early adopters.
• Resistant to abrasion
• Stable interface to the bone
• Simple surgical procedure
• Unbraided, uncoated continuous loop ultra-high molecular weight polyethylene (UHMWPE) Dyneema® suture material
• Titanium Alloy (TAN) bone anchor screw
• Mono-crystalline Ruby eyelet
• Titanium Alloy (Grade 5) link
• Polyether ether ketone (PEEK) link lock
• > 1,000 N static strength of all components (size 4.5 for 15 – 30 kg patients)
• Lateral approach only
• Minimal Instrumentation
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