There are an estimated , ACL repairs in the US each year: most ACL tears occurs from noncontact injuries. The % of the knee ligament injuries. Among femoral cortical suspension devices, the EndoButton CL . to confirm the position of the EndoButton after ACL reconstruction (Fig 3). One device used for femoral fixation of ACL grafts is the EndoButton Continuous Loop (Smith & Nephew. Endoscopy, Andover, Mass). This device has been well.

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Over the top or endobutton for ACL reconstruction?

A fixed-loop cortical suspension device, the EndoButton CL, is used for femoral fixation. Several studies have shown that EndoButton malpositioning over the soft tissue around the knee induces either tissue irritation or migration of the button. The Endotape rupture was the most common failure mode.

Find articles by Hajime Utsunomiya. Success of surgery is totally dependent on the ability of the implant to secure the graft inside the bone tunnel until complete graft integration. The laxity is related to loss of fixation by elongation of the graft, graft slippage, and plastic deformation of device.

A cyclic loading test was applied with N of tensile force at 1 Hz for cycles. Migration of EndoButton after anatomic double-bundle anterior cruciate ligament reconstruction.

There is a risk of damage to the EndoButton loop by using the Vulcan. In general, suspension of the EndoButton over soft tissue, such as the ITB, was weaker than that on the femoral cortex. Please review our privacy policy. The techniques allows direct visualization of the reduction of the migrated EndoButton.


Do adjustable loops lengthen? Supplementary Data Video 1: Furthermore, the slippage impairs the integration and ligamentization process Rodeo et al. We describe an arthroscopic technique for endobuton femoral tunnels through the endobuhton method that reduces the migration of the EndoButton through a lateral femoral portal. Three femoral fixation devices for anterior cruciate ligament reconstruction: The anchor point, however, is different. The stiffness decreases and the fixation tends to fail.

An ipsilateral semitendinosus and gracilis autograft is used in every case. Failure during cyclical loading was assumed to occur in cases in which a complete slippage of the fixation device was observed. Discussion Studies in animal models have been widely realized to understand the biomechanical zcl of several devices to fix the hamstring tendons in the femoral side in ACL reconstruction.

Mechanical comparison of biodegradable femoral fixation devices for hamstring tendon graft – A biomechanical study in a porcine model.

This failure mode occurred in 5 cases. The advantage of using animal bone is its mineral density likeness and easy acquisition. Journal of Bone and Joint Surgery.

Femoral fixation solution for ACL reconstruction | Smith & Nephew – Corporate

Make an LF portal by longitudinally extending the guide pin incision. A 6 mm diameter bone tunnel was drilled in inside-out technique to the EndoButton fixation. As a result, the button pulled out from the cortical bone Ahmad et al. A 6 mm over-the-top guiding device was used to locate the anatomical ACL insertion. The Bio Cross-Pin Weight-bearing exercise as tolerated with crutches is also initiated immediately.


However, this technique requires a longer intraoperative time and a relatively higher level of surgical skills that may ednobutton its use to more experienced surgeons.

Over the top or endobutton for ACL reconstruction?

The previous studies showed a positive correlation between a malpositioned EndoButton and a higher rate of button migration. The laxity during cyclic loading and the displacement to failure during single-cycle test were lower for the Bio Cross-Pin fixation 8.

In theory, this effect causes expansion and compression of the graft against the tunnel wall resulting in highest strength Milano et al. The procedure was sufficiently accurate for the purposes of this study, in accordance with clinical practice Kousa et al. Knee Surgery, Sports Traumatology, Arthroscopy. Theoricaly, this point represents the fixation resistance before yielding. Mechanical behavior of two hamstring graft constructs for reconstruction scl the anterior cruciate ligament.

Journal of Biomedical Materials Research. Further research is needed to determine the clinical relevance of these findings relating the ACL replacement at femoral side. The yield loading displayed by both fixations was sufficient to support the loading applied during daily tasks and accelerated rehabilitation programs.

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