Finished Product

AR-1297-02

Human

Knee

Procedure

Arthrex offers a comprehensive selection of fixation devices for a variety of bone-patellar tendon-bone (BTB) graft techniques. These options include adjustable, continuous-loop suspensory fixation, and interference screws in a variety of materials. The TightRope® implant, which has been used in 2 million procedures globally,1 was designed to simplify ACL reconstruction and facilitate advanced techniques, such as the GraftLink® technique. BioComposite FastThread™ interference screws, which are composed of time-tested material with more than a decade of clinical success and implantation, allow for faster screw insertion and better graft protection.2
References
1. Arthrex, Inc. Data on file (sales data as of September 18, 2018). Naples, FL; 2018.
2. Arthrex, Inc. LA1-0199-EN_E. Naples, FL; 2018.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

BTB Autograft ACL Reconstruction 

Child (D)

There has been a renewed interest in ACL primary repairs as the treatment for Sherman type I and type II ACL ruptures. Careful analysis of historical data has revealed that certain ACL tear subgroups, especially proximal tears with good tissue quality, have positive clinical outcomes with primary ACL repair.1
Studies reporting outcomes of remnant-preserving ACL surgeries have shown encouraging results and a greater potential for early healing and better functional outcomes compared with remnant-resecting surgeries.2 Preservation of the native ACL using the primary repair technique can achieve short-term clinical success and result in good clinical outcomes at 3-year follow-up in this carefully selected patient population.3
Arthroscopic primary repair is minimally invasive because no grafts need to be harvested, no graft tunnels or sockets need to be drilled, and revision surgery, if necessary, is more analogous to primary reconstructions.4 The goal of the procedure is to preserve the remnant native ligament. By doing this, the native nerve endings and blood supply are preserved.5
References
1. van der List JP, DiFelice GS. Role of tear location on outcomes of open primary repair of the anterior cruciate ligament: a systematic review of historical studies. Knee. 2017;24(5):898-908. doi:10.1016/j.knee.2017.05.009
2. van der List JP, DiFelice GS. Successful arthroscopic primary repair of a chronic anterior cruciate ligament tear 11 years following injury. HSS J. 2017;13(1):90-95. doi:10.1007/s11420-016-9530-8
3. Jonkergouw A, van der List JP, DiFelice GS. Arthroscopic primary repair of proximal anterior cruciate ligament tears: outcomes of the first 56 consecutive patients and the role of additional internal bracing. Knee Surg Sports Traumatol Arthrosc. 2019;27(1):21-28. doi:10.1007/s00167-018-5338-z
4. DiFelice GS, Villegas C, Taylor S. Anterior cruciate ligament preservation: early results of a novel arthroscopic technique for suture anchor primary anterior cruciate ligament repair. Arthroscopy. 2015;31(11):2162-2171. doi:10.1016/j.arthro.2015.08.010
5. DiFelice GS, van der List JP. Arthroscopic primary repair of proximal anterior cruciate ligament tears. Arthrosc Tech. 2016;5(5):e1057-e1061. doi:10.1016/j.eats.2016.05.009

ACL Repair

Product

An innovative approach to ACL preservation, the ACL Repair TightRope implant enables precise, incremental repair tensioning and retensioning. Additionally, the FiberRing suture allows for simplified and reproducible suture passing and implant loading. Careful analysis of historical data has revealed that certain ACL tear subgroups, especially proximal tears with good tissue quality, have positive clinical outcomes with primary ACL repair.1
Reference
1. Arthrex, Inc. Data on file (DOC1-000178-en-US_B). &nbsp;Naples, FL; 2020.

ACL Repair TightRope® Implant With FiberRing™ Sutures

Arthrex offers the most advanced techniques and instruments for hamstring harvesting and preparation for ACL reconstruction. A reproducible harvest can be performed through a traditional anterior or posterior approach using the minimally invasive hamstring harvest technique and specialized tendon strippers.
The GraftLink®&nbsp;technique provides an anatomic, minimally invasive, and reproducible ACL reconstruction procedure. When used in combination with anatomic guides, the FlipCutter® III drill allows independent femoral and tibial "retrodrilling" to create sockets while maintaining the cortices to maximize fixation. Femoral and tibial TightRope® II implants, with a proprietary 5-point locking system, make the GraftLink technique the most reproducible ACL reconstruction available.
Anatomic: Independent tibial and femoral socket preparation with FlipCutter III reamer and/or low-profile reamers facilitate unconstrained placement of the ACL graft.
Minimally Invasive: Socket preparation with the FlipCutter III reamer limits soft-tissue dissection and helps preserve bone and periosteum.
Reproducible: The GraftPro® graft prep system simplifies graft preparation; the tapered graft and adjustable ACL TightRope II buttons facilitate graft passing, fine tuning of graft depth, and graft tensioning from the femoral and tibial sides.

Hamstring Autograft ACL Reconstruction

MCL reconstruction is typically performed when the MCL is severely injured or in cases of chronic MCL laxity. During an MCL reconstruction, autograft or allograft tissue is used to reconstruct the injured ligament. Graft-fixation technology for MCL reconstruction has evolved from staples, posts and washers, and interference screws to less invasive and easier-to-use suspensory fixation, including the TightRope® implant, and 
all-suture anchor technology, such as the Knee FiberTak® anchor.&nbsp;
Adding the InternalBrace™ technique to an MCL repair may result in lower failure rates and less residual laxity post-op as well as shorter immobilization times and faster return to play.1 Additionally, FiberTape® suture has been used for more than 15 years in more than 4 million cases, including tendon and ligament-bridging repairs.
The InternalBrace surgical technique is intended only to support the primary repair and is not intended as a replacement for the standard of care using biologic augmentation in a primary repair.&nbsp;The InternalBrace surgical technique is intended only for soft-tissue-to-bone fixation and is not cleared for bone-to-bone fixation.
Reference
 
1. van Eck CF, Nakamura T, Price T, Linde M, Smolinski P. Suture tape augmentation improves laxity of MCL repair in the ACL reconstructed knee.&nbsp;Knee Surg Sports Traumatol Arthrosc. 2021;29(8):2545-2552. doi:10.1007/s00167-020-06386-7

Medial Collateral Ligament (MCL) Reconstruction

Ruptures of the quadriceps and patellar tendons are common in elite and recreational athletes. Most surgeons treat these injuries surgically to lessen the risk of long-term disability and morbidity.&nbsp;
Historically, open techniques have been used for rupture repairs, but these techniques may be complicated by wound-healing issues and infection. The minimally invasive Percutaneous Achilles Repair System (PARS) technique can be used to treat quadriceps, patellar, and Achilles tendon ruptures.

Patellar Tendon Repair

A technique gaining popularity, PCL repair is generally indicated for bony avulsions that can occur on either the femur or tibia.&nbsp;
PCL injuries can happen during sports-related activities or high-velocity, traumatic accidents. Applications for operative treatment of PCL tears include acute injuries, tears in active young patients, and either isolated grade 3 tears or a combined injury, such as grade 2 tears with posterolateral corner instability.
PCL tears can be treated with innovative, minimally invasive procedures using the PCL Repair TightRope® implant and FiberRing™ sutures.

Posterior Cruciate Ligament (PCL) Repair 

Quadriceps tendon grafts offer unique benefits for cruciate ligament reconstruction, such as a predictably large diameter, low morbidity,1 and a preferable stiffness profile for knee ligament reconstruction.
The QuadPro™ tendon harvester is designed to harvest a quadriceps or patellar tendon graft using a minimally invasive technique.2-4 The sharp tip cores out an approximate cylindrical graft. The harvester's ergonomically designed handle features graduations on the clear shaft to allow visualization of approximate graft length during harvesting. Available in four sizes (8 mm to 11 mm), the QuadPro tendon harvester can accommodate each patient’s unique needs as well as the surgeon’s preference for graft diameter.
The FiberTag® TightRope® implant facilitates attachment of single-ended grafts, such as quadriceps tendon grafts, to the ACL TightRope RT and ABS implants. FiberTag suture is integrated into the TightRope implant for a strong, consistent connection between the suture and TightRope loop. A simplified suturing technique, along with innovative packaging and the GraftClamp graft preparation instrument, make preparing quadriceps tendon grafts faster and more reproducible than ever.
References
1. Arthrex, Inc. LA1-00100-EN_K. Naples, FL; 2021.
2. Xerogeanes JW, Mitchell PM, Karasev PA, Kolesov IA, Romine SE. Anatomic and morphological evaluation of the quadriceps tendon using 3-dimensional magnetic resonance imaging reconstruction: applications for anterior cruciate ligament autograft choice and procurement. Am J Sports Med. 2013;41(10):2392-2399. doi:10.1177/0363546513496626
3. Hadjicostas PT, Soucacos PN, Berger I, Koleganova N, Paessler HH. Comparative analysis of the morphologic structure of quadriceps and patellar tendon: a descriptive laboratory study. Arthroscopy. 2007;23(7):744-750. doi:10.1016/j.arthro.2007.01.032
4. Krebs N, Yaish A, O’Neill N. Anatomic evaluation of the quadriceps tendon in cadaveric specimens: application for anterior cruciate ligament reconstruction graft choice. SMRJ. 2019;4(1):7961. doi:10.51894/001c.7961

Quad Tendon Autograft ACL Reconstruction

Ruptures of the quadriceps and patellar tendons are common in elite and recreational athletes. Most surgeons treat these injuries surgically to lessen the risk of long-term disability and morbidity. Historically, open techniques have been used for rupture repairs but may be complicated by wound-healing issues and infection. The minimally invasive Percutaneous Achilles Repair System (PARS) technique can be used to treat quadriceps, patellar, and Achilles tendon ruptures.
The PARS technique helps facilitate consistent capture of the distal aspect of the quadriceps tendon and includes color-coded FiberWire® and FiberTape® sutures. The anatomically contoured guide is reusable, while the suture and passing needles come packaged in a convenient kit. Choose transverse suture, locking suture, or both. The colored FiberWire sutures offer a more organized approach to identifying and securing matched pairs.

2.4 mm Guide Pin

AR-1297-02

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