Innovation offers an anchor-free approach to rotator cuff repair, particularly for patients with poor bone quality
BENGALURU | 16th SEPTEMBER 2026 | Turning a challenging surgical experience into an indigenous medical innovation, Dr Banarji B.H., Additional Director – Orthopaedics at Sakra World Hospital, Bengaluru, has been granted an Indian Patent by the Patent Office, Government of India, for his invention titled “Apparatus for Trans-Osseous Rotator Cuff Repair.”
The patented apparatus is designed to enable rotator cuff repair through bone tunnels rather than conventional suture anchors. The approach may be particularly useful in patients with poor bone quality, including elderly patients and those with osteoporosis, where conventional anchors may not achieve adequate fixation.
Discovery of the patented innovation
The idea for the invention emerged during a challenging rotator cuff repair in a patient with poor bone quality. During the procedure, Dr Banarji found that the bone was not providing adequate purchase for conventional anchor fixation. Rather than compromising the quality of the repair, he explored an alternative approach that involved repairing the tendon through the bone itself. This successful experience prompted him to develop the concept further and design an apparatus that could facilitate trans-osseous rotator cuff repair. The innovation was developed and refined over approximately three to four years, drawing extensively on Dr Banarji’s surgical experience and clinical observations.
In conventional repair, suture anchors are placed into the bone to secure the torn tendon back to its attachment site. However, when bone quality is poor, the anchor may not achieve sufficient fixation, making the repair more technically challenging. The patented apparatus provides surgeons with an alternative method of fixation that does not rely on conventional suture anchors.
How the apparatus works
The apparatus facilitates the creation and connection of bone tunnels through which sutures can be passed to secure the torn rotator cuff tendon. In the trans-osseous technique, a tunnel is created in the bone adjacent to the cartilage and connected to a second tunnel using the specially designed apparatus. Sutures are then passed through the tunnels and the tendon, allowing the tendon to be secured back to the bone.
The procedure is performed arthroscopically, with the tunnels created and connected from medial to lateral before the sutures are passed and the repair is completed.
Potential clinical benefits
The trans-osseous approach also has a potential biological advantage. Creating a bone tunnel exposes the repair site to bone marrow contents, including growth factors and stem-cell-containing elements, which may contribute to the biological environment for tendon-to-bone healing.
As the technique does not require conventional suture anchors, it may also reduce dependence on implant-based fixation; implant-related complications will be avoided, and potentially have cost implications in appropriate cases.
Dr Banarji B.H., Additional Director – Orthopaedics, Sakra World Hospital, Bengaluru, and inventor of the apparatus, said: “The idea for this innovation came from a difficult rotator cuff repair in a patient with poor bone quality, where conventional anchor fixation was challenging. Instead of compromising on the repair, I explored the possibility of securing the tendon through the bone. That experience led me to develop and refine an apparatus that could facilitate this approach. Receiving the patent is an important milestone because it represents the journey from an operating-room problem to a potential solution. My objective is to provide surgeons with another option, particularly when poor bone quality makes conventional anchor-based repair difficult, while contributing to indigenous innovation in orthopaedic surgery.”
Mr Yuichi Nagano, Managing Director, Sakra World Hospital, said, “Dr Banarji’s patented apparatus is a strong example of how clinical challenges can inspire indigenous medical innovation. We congratulate him on this achievement and remain committed to supporting clinician-led innovation that can advance patient care.”
Mr Kei Iiyama, Deputy Managing Director, Sakra World Hospital, said, “Dr Banarji’s innovation reflects how clinical challenges can lead to practical solutions that have the potential to improve patient care. This patent is a proud milestone for Sakra and reinforces our commitment to supporting clinician-led research and innovation.”
Mr Lovekesh Kumar Phasu, Group Chief Operating Officer, said, “This patent is a testament to the value of nurturing indigenous medical innovation within our healthcare ecosystem. We remain committed to empowering our clinicians to transform insights from clinical practice into solutions that can contribute to advancing patient care.”
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