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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Author information Article notes Copyright and License information Disclaimer. When the failure did not occur in the Endotape, the displacement-load curve showed a different pattern.

The Journal of Arthroscopic Related Surgery. A biomechanical analysis of matched bone-patellar tendon-bone and double-looped semitendinosus and gracilis tendon grafts. There was no significant difference between Bio Cross-Pin failure loading: This procedure, however, requires great care at postoperative period. Clinical Biomechanics Bristol, Avon. EndoButton external cortical support point.

A two-way split-plot ANOVA was used fixation technique — between factor; and displacement by cycles — within factor to test laxity during cyclic loading. Fixation strength of interference screw fixation in bovine, young human, and elderly human cadaver knees: Our technique cannot be applied in the case of a migrated EndoButton resulting from malpositioning of the femoral bone tunnel.

Both are able to support the immediate post-operative loading applied N.

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

The anterior cruciate ligament ACL replacement with hamstring graft has been endoubtton performed with positive results. Immediately after the graft fixation, each femur was clamped to a custom device with bone cement PMMA and screws.

Studies in animal models have been widely realized to understand the biomechanical performance of several devices to fix the hamstring tendons in the femoral side in ACL reconstruction. The probability level was set at 0. The existence of different methods makes it difficult to compare results.

Over the top or endobutton for ACL reconstruction?

In vitro comparison between cortical and cortico-cancellous femoral suspension devices for anterior cruciate ligament reconstruction: In general, suspension of the EndoButton over soft tissue, such as the ITB, was weaker than that on the endobuttoj cortex. Tendon-healing in a bone tunnel: Seating of TightRope RT button under direct arthroscopic visualization in anterior cruciate ligament reconstruction to prevent potential complications.


Several techniques have been proposed to ensure accurate endobuutton of the EndoButton and lessen the probability of malpositioning. The trans-iliotibial band endoscopic portal for direct visualization of ideal button placement. Ultimate failure load N.

Fourteen porcine knees of Landrace specimens with 2 years old and kg weight were purchased from a commercial slaughterhouse in the state ready for consumption.

An ipsilateral semitendinosus and gracilis autograft is used in every case. Therefore, the best way to assess the Bio Cross-Pin and EndoButton performance is to apply the loading directly at the graft. This technique requires careful cleaning of the soft tissue over the lateral cortex of the femur. The values for the ultimate failure load, yield point load, displacement at ultimate failure load, displacement at yield load, linear stiffness, and energy were obtained from the load-displacement curves Hz sampling rate.

This Technical Note describes an arthroscopic technique to prevent migration of the EndoButton using a femoral guide pin incision on the lateral aspect of the femur as an endoscopic portal. Postoperative clinical examination before revision showed range of motion without increased resistance. Despite a lack of similar methods, however, the results obtained at present work endobuutton similar with others from literature Ahmad et al. Despite any difference in strength observed during the failure test, Bio Cross-Pin was stiffer than EndoButton.

In theory, the stiffness is an important variable to be considered. The tunnel was drilled to match the graft diameter. Knee Surg Sports Traumatol Arthrosc. Our arthroscopic reduction technique allows the surgeon to assess for malpositioning and migration of the EndoButton directly through the LF portal and remove any soft tissue interposed between the EndoButton and the lateral cortex of the femur.

An unidentified pitfall of Endobutton use: Therefore, the aim of this study was to assess the mechanical properties and the failure mode of Bio Cross-Pin and EndoButton with respect to the fixation of Hamstring graft. A variety of testing parameters were used in these studies, including the use of femur-graft-tibia endobufton, the direction of pulling out the tendon, the rate of loading, and cyclic test protocol.


Journal List Arthrosc Tech v. Postoperative Rehabilitation A standardized postoperative protocol is implemented for each patient. However, the interpretation of implant performance at femoral site testing the whole complex may be difficult since that the fixation on the tibia fail before that on femur fails Shen et al. Results The laxity during cyclic loading and the displacement to failure during single-cycle test were lower endkbutton the Bio Cross-Pin fixation 8.

The yield loading displayed by both fixations was sufficient to support ejdobutton loading applied during daily tasks and accelerated rehabilitation programs. A Vulcan probe can also be inserted through the same portal to help manipulate and fit the EndoButton into the proper position at the lateral cortex of the femur by pulling the graft on the tibial side Fig 2 D and E. These results, however, help us understand the biomechanical performance of the fixation, when submiting the device to a worst case condition.

This failure mode occurred in 5 cases. Journal of Arthroscopy and Related Surgery. Hamstring tendon grafts for reconstruction of the anterior cruciate ligament: The second aspect to be noted is the direction of bone tunnel axis during graft tension testing. On the Bio Cross-Pin fixation a 9 mm tunnel diameter was drilled for the graft positioning.

Published online Oct Mechanical comparison of biodegradable femoral fixation devices for hamstring tendon graft – A biomechanical study in a porcine model. The zcl passes around this pin to be fixed. Fixation technique The fixation procedure followed the same clinical protocol established for ACL reconstruction at femoral side of human knees.

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