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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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These manoeuvres can often redirect the drill tip guide pin more proximally up the femoral shaft, producing a longer femoral tunnel length. Journal of Biomedical Materials Research. Dilate the AAM portal by inserting the tips of the Metzenbaum scissors or a small curved clamp into the incision and spreading the tips in-line with the direction of the portal. This technique requires careful cleaning of the soft tissue over the lateral cortex of the femur.

How to cite this article. 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.

Moreover, the pain intensity score were 2. This article has been cited by other articles in PMC.

Previous studies have observed that the porcine bone did not resist the load applied. Remnant fibres of the native ACL are seen along the lateral wall of the notch. No significant difference of ultimate failure load, yield load, and energy was observed between the Bio Cross-Pin and EndoButton fixation. It is worth noting that some methods used in techniqhe experiment should be highlighted.

Cross pins versus endobutton femoral fixation in hamstring anterior cruciate ligament reconstruction: Furthermore, the bone quality Brown et al. The inability of a vertically axl ACL graft to control these combined motions may result in the patient experiencing continued symptoms of instability due to the pivot-shift phenomenon.

Confirm the migration of the EndoButton to the lateral cortex of the knee through the LF portal. Anatomical studies have demonstrated that the ACL femoral attachment site is defined by two osseous ridges [ 9 ]. 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.


Therefore, to evaluate the Cross-Pin and EndoButton performance for femoral fixation we apply the load directly on the graft. However, there are no remnants of the native ACL fibres visible.

Avoid using a curette, motorised shaver blade or burr to initially perform a notchplasty or to completely remove all of the soft tissue remnants from the lateral wall of the notch as this destroys the remaining native ACL fibres and underlying bony landmarks.

Physical therapy, consisting of exercise without resistance, to improve range of motion is initiated immediately after surgery. J Bone Joint Surg Am. Biomechanical comparison of Cross-Pin and Endobutton femoral fixation of a flexor tendon graft for anterior cruciate ligament reconstruction – A porcine femur-graft-tibia complex study. Mechanical testing Immediately after the graft fixation, each femur was clamped to a custom device with bone cement PMMA and screws. 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.

ACL Technique: Endoscopic Hamstring Graft with Endobutton

Intraoperative quality control of the placement of bone tunnels for the anterior cruciate ligament. The advantages of this arthroscopic technique include small incisions and direct visualization that can help remove any soft-tissue interposition and reduce tecnhique migrated EndoButton. AM portal view in hyperflexion.

Double-bundle reconstruction of the anterior cruciate ligament.

Long and wide ACL tibial attachment sites are best restored with larger diameter ACL grafts such as five- and six-strand hamstring tendon grafts, a bone-patellar tendon-bone graft, a quadriceps tendon graft or by performing a double-bundle ACL reconstruction [ 8 ].

Distribution of basic data of study patients Click here to view. The trans-iliotibial band ednobutton portal for direct visualization of ideal button placement.

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

Excessive introduction of fluid may increase the risk of compartment syndrome. The yield loading displayed by both fixations was sufficient to support the loading applied during daily tasks and accelerated rehabilitation programs.


Weight-bearing exercise as tolerated with crutches is also initiated immediately.

A high AL portal places envobutton arthroscope above the widest part of the fat pad, minimising interference of the visual field in the intercondylar notch when the knee is placed in hyperflexion.

Comparison between techhnique femoral fixation devices for ACL reconstruction with doubled hamstring tendon graft: If the fat pad still obscures visualisation, limited resection of the fat pad should be performed using a motorised shaver blade inserted through the AAM. Tendon healing in a bone tunnel.

The laxity during cyclic loading and the displacement to failure during single-cycle test were lower for the Bio Cross-Pin fixation 8. A new techniwue ACL femoral tunnel was drilled through an AAM portal bypassing the original non-anatomical femoral tunnel.

The fixation procedure followed the same clinical protocol established for ACL reconstruction at femoral side of human knees.

ACL Technique: Endoscopic Hamstring Graft with Endobutton

Biomechanical study of different internal fixations with Chinese hamstring tendon in anterior cruciate ligament reconstruction. 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. Staubli HU, Rauschning W. A more oblique orientation of the guide pin will increase the length of the ACL femoral tunnel and produce a more elliptically shaped femoral tunnel aperture [ 7 ].

The Cross-Pin is based on graft expansion. Offset ACL aimers can constrain the location of the femoral guide pin and can lead to non-anatomical placement of the ACL femoral tunnel. Histologic analysis after biodegradable interference fit fixation in a model of anterior cruciate ligament reconstruction in sheep.