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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The additional medial portal ttechnique the ACL femoral attachment site to be viewed through the AM portal, while working instrumentation is inserted into the notch through the AAM portal.

ACL Technique: Endoscopic Hamstring Graft with Endobutton

Yasuo OhnishiM. The Journal of Arthroscopic Related Surgery. With the knee in extension, the relative height of the two foot rests can be adjusted such that the knee can endobuutton maintained at a known flexion angle during tensioning and fixation of the ACL graft Fig.

Previous studies have shown that ligament loads of this magnitude can be generated during quadriceps muscle contraction at full knee extension Rupp et al. The Bio Cross-Pin broke in 5 cases, and the tendon failed in 2 cases. ACL reconstruction performed using a transtibial tunnel technique often results in a vertical ACL graft, which may fail to control the combined motions of anterior tibial translation and internal tibial rotation which occur during the pivot-shift phenomenon. A disadvantage of using our arthroscopic technique is the potential risk of compartment syndrome after excessive introduction of fluid in the LF portal.

Pass the passing enodbutton for the ACL graft through the suture loop and pass them out of the lateral thigh. The fixation device should promote stiffness near endobuttln native ACL to avoid an excessive graft motion and knee laxity until graft integration, To et al.

The femoral site becomes the weak point in this case. 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.


This factor makes the early postoperative period a critical axl for successful surgery Becker et al. A longer tibial tunnel minimises the potential for graft-tunnel length mismatch and allows longer bone-tendon-bone graft constructions to be used.

Please review our privacy policy. How to cite this article: The method used in our study did not represent the functional loading applied to the graft during flexion-extension movement Zhang et al.

None, Conflict of Interest: The proposed procedure is routinely used in our practice and continues to show promise. Moving the AAM portal more laterally, towards the medial border of the patellar ligament, orientates the femoral bit more obliquely with respect to the lateral wall of the notch and produces a longer ACL femoral tunnel length and a more elliptically shaped tunnel aperture Fig.

Conclusion The results obtained in this experiment indicate that the Bio Cross-Pin technique promote stiffer fixation during cyclic loading as compared with EndoButton. All-inside anterior cruciate ligament graft-link technique: Anterior cruciate ligament reconstruction: Note that in this particular case, the centre of the ACL femoral attachment site lies slightly endobuttonn proximal to the lateral bifurcate ridge.

Clinical and functional outcomes after anterior cruciate ligament reconstruction using cortical button fixation versus transfemoral suspensory fixation: The ACL ruler has been bent to lie flat along the lateral wall of the intercondylar notch. Offset ACL aimers can constrain the location of the femoral guide pin and can lead to non-anatomical placement of the ACL femoral tunnel.

ACL femoral tunnel placement is more accurately defined and specified using the following methods:. Potential pitfall of the EndoButton.

In theory, the stiffness is an important variable to be considered. Our arthroscopic reduction technique allows the surgeon to assess for endohutton and migration of the EndoButton directly through the LF portal and remove any soft tissue interposed between tdchnique EndoButton and the lateral cortex of the femur. The diameter of Cross-Pin is higher than Endotape, increasing the volume when the tendon loops.

This article has been cited by other articles in PMC. Hyperflexion of the knee results in a loss of joint distension due to external compression of the knee joint capsule by the soft tissues of the thigh. Iatrogenic damage to the cartilage of the medial femoral endobutto is more likely to occur in the situation where a ten millimetre drill bit is used to drill the femoral socket for a bone-patellar tendon-bone or bone-quadriceps tendon graft. Avoid drilling the tibial guide pin completely into the knee joint as this will result in the guide pin hitting nedobutton tip of the tibial aimer and deflecting away from its intended target.


Hamstring tendon autograft better than bone patellar-tendon bone autograft in ACL reconstruction: The Cross-Pin is based on graft expansion.

Anatomical ACL 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. One of the most common orthopedic clinic visits involves direct and indirect knee trauma leading to rupture of anterior cruciate ligament ACL.

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

ACL Technique: Endoscopic Hamstring Graft with Endobutton

There is a paucity of available literature regarding how to best remove interposed soft tissue and reduce the position of the EndoButton. Establish a high AL portal at the level of the inferior pole of the patella, as close as possible to the lateral border of the patellar tendon using a 11 knife blade. AM portal view in hyperflexion. ACL reconstruction using the Rigidfix femoral fixation device via the anteromedial portal: The ACL femoral tunnel is drilled independently of the tibial tunnel, which allows for consistent placement of the femoral tunnel within the native ACL femoral attachment site.

Raise or lower the handle of the tibial guide aimer until the mark on the bullet is endobhtton at the end of the aimer handle when the bullet is flush with the anterior cortex of the tibia.