PDF | The technique for endobutton femoral fixation of double semitendinosus/ double gracilis hamstring anterior cruciate ligament (ACL). Find out all of the information about the Smith & Nephew product: ACL reconstruction suture button ENDOBUTTON. Contact a supplier or the parent company. ACL reconstruction performed using a transtibial tunnel technique often .. to be inserted into the ACL femoral socket when using a 15 mm ENDOBUTTON CL.

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Anatomical Tefhnique reconstruction requires an understanding of ACL insertion anatomy and an understanding of the various methods currently used to identify the anatomy and to identify the true insertion points. Postoperative clinical examination before revision showed range of motion without increased resistance. The spinal needle position is too low if it enters the knee joint below the level of the roof of the intercondylar notch or passes through the fat pad.

Tibial attachment area of the anterior cruciate ligament in the extended knee position. This is positioned accl higher than the normal position for standard arthroscopic procedures.

This more accurate technique not only allows endogutton better visualization but also leads to a decrease in the rate of failure of the Aco reconstruction. Therefore, the surgeon can opt to drill a steeper and thus longer tibial tunnel. This manoeuvre increases the obliquity of the guide pin relative to the lateral wall of the notch, resulting in a longer femoral tunnel techique and a more elliptically shaped tunnel aperture Fig. The tibial guide pin can be moved in the desired direction and the tibial tunnel drilled sequentially by one millimetre increments up to the desired size of the tunnel using an endoscopic drill bit.

The lateral intercondylar ridge is most easily identified by starting the dissection in the lower part of endoutton footprint and working in the superior high direction. This technique may assist surgeons in understanding how to deal with and potentially avoid EndoButton migration during anterior cruciate ligament reconstruction.


The laxity is related to loss of fixation by elongation of the graft, graft slippage, and plastic deformation of device. Clinical studies have demonstrated that non-anatomical ACL graft placement is the most common technical error leading to recurrent instability following ACL reconstruction [ 12 ].

Journal List Int Orthop v.

No fixation devices failed during the cyclic loading test. Although they suggested that an increased angle of knee flexion was more likely to result in soft-tissue interposition before flipping, they did not describe any complications resulting from the failure of flipping. One is the use of animal tissues.

ACL reconstruction suture button – ENDOBUTTON – Smith & Nephew

There was no significant difference between Bio Cross-Pin failure acp Slowly drill the 2. Epidemiology of athletic knee injuries: The probability level was set at 0. Positioning the tibial guide pin too far laterally in the ACL tibial attachment site can result in impingement of the ACL graft against the lateral wall of the notch.

Another potential complication is lateral extravasation because this technique is performed in the extra-articular space. However, due to the height of the AL portal above the lateral joint line, in some knees it may be more difficult to position the ACL ruler lower down the sidewall of the notch at the ACL femoral attachment site.

In the transtibial technique, positioning the ACL tibial tunnel in the posterior half of the ACL tibial attachment site is dictated by the need for the arthroscopic drill bit to reach the region of the ACL femoral attachment site and the desire that the ACL graft avoid impingement against the roof of the intercondylar notch when the knee is in full extension.

Journal of Orthopaedic Research. Statistical analysis A two-way split-plot ANOVA was used fixation technique — between factor; and displacement by cycles — within factor texhnique test laxity during cyclic loading. ACL femoral tunnel placement is more accurately defined and specified using the techjique methods: The tunnel was endobuttno to match the graft diameter.

Apply a thigh length anti-embolism stocking and a foam heel protector to the non-operative technuque.

ACL Technique: Endoscopic Hamstring Graft with Endobutton

ACL reconstruction using the medial portal technique is facilitated by using three arthroscopic portals Fig. This limitation may be encountered in some obese patients, in which case consideration should be given to drilling the ACL femoral tunnel using an outside-in technique or using flexible reamers.


E The position of the EndoButton arrow is fixed to the lateral aspect of the femoral cortex. The arrowhead indicates the Vulcan probe. As a result, the AM portal is the preferred portal for viewing the anatomical ACL femoral attachment site.

Endobutton CL versus Rigidfix fixation systems for fixation of autologous quadrupled hamstring tendon in anterior cruciate ligament reconstruction. The yield load has been advocated as the most important variable to be evaluated in the performance of fixation Kousa et al. Clinical Biomechanics Bristol, Avon. Weight-bearing exercise as tolerated with crutches is also initiated immediately. The button is supported by the external cortical portion of the bone Endotape links the graft to the not supported central part of the metallic button.

Contributions of enxobutton fixation methods to the stiffness of anterior cruciate ligament replacements at implantation. Journal of Bone and Joint Surgery. Previous studies have shown that the biomechanical performance of the Bio Cross-Pin is superior that the EndoButton during cyclic and failure loading test Ahmad et al.

In vitro comparison between cortical and cortico-cancellous femoral suspension devices for anterior cruciate ligament reconstruction: Similar to any surgical technique, there is a learning curve to the medial portal technique for ACL reconstruction.

Journal of Biomedical Materials Research. Validation of a new technique to determine midbundle femoral tunnel position in anterior cruciate ligament reconstruction using 3-D computed tomography analysis.

A systematic review of randomized controlled trials. Does the lateral intercondylar ridge disappear in ACL deficient patients. Open in a separate window. The Cross-Pin is based on graft expansion.

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