Finished Product

AR-1588TB-17

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)

Product

The TightRope attachable button system (ABS) revolutionized minimally invasive, adjustable-loop suspensory fixation grafts used in knee ligament surgery. Suitable for all graft types, TightRope II ABS implant loops can be attached to a variety of button configurations for fixation over sockets created with a FlipCutter® drill or full tunnels with concave buttons.&nbsp;
The flat-tape TightRope II ABS implant loop improves handling characteristics and can reduce graft abrasion.1 Able to easily pass through narrow bone tunnels, the two-piece TightRope II ABS implant allows increased cortical fixation with the assembly of a large button over the cortical bone. During all-inside ACL reconstruction, use the TightRope II ABS implant for tibial fixation in QuadLink™ and GraftLink® techniques or graft fixation over small bone tunnels created during transtibial ACL reconstruction.
Reference
1. Arthrex, Inc. Data on file (LA1-00038-EN_B). Naples, FL; 2017.

TightRope® II Attachable Button System

As the first adjustable-loop cortical suspensory fixation implant to use a flat SutureTape design, the ACL TightRope II implant offers better handling characteristics and is more resistant to graft abrasion or tissue pull-through than traditional round sutures.1&nbsp;
Engineered for precise graft tensioning, the adjustable-loop mechanism allows for incremental retensioning of the graft construct after the implants have been secured on the cortex. The redesigned cortical button now incorporates a proprietary knotless fifth locking mechanism, increasing strength and resistance to cyclic displacement.2 To accommodate various graft types and techniques, TightRope II implants are available in RT and BTB configurations loaded with an additional flipping suture or preloaded with a FiberTape® suture for the InternalBrace™ technique. Available options for the ABS implant include standard or open.
References
1. Arthrex, Inc. LA1-00038-EN_B. Naples, FL; 2017.
2. Arthrex, Inc. Data on file (APT-G01155). Munich, Germany; 2020.
The InternalBrace surgical technique is intended only to augment the primary repair/reconstruction by expanding the area of tissue approximation during the healing period and is not intended as a replacement for the native ligament. The InternalBrace technique is for use during soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation.

ACL TightRope® II Implant

Orthobiologics

The BioACL technique harnesses the power of next-generation biologics to provide the ultimate anatomic, minimally invasive, reproducible approach for taking patient outcomes to the next level.
By prefilling ACL bone tunnels with a powerful composite of concentrated platelet-rich plasma (cPRP) from bone marrow aspirate (BMA) or whole blood processed with the Angel® system, the patient’s own bone collected with the GraftNet™ device, and AlloSync® Pure demineralized bone matrix, the BioACL technique provides all the necessary healing components for an ACL reconstruction procedure.
In conjunction with the QuadLink™ with InternalBrace™ technique, the BioACL technique has been shown to result in earlier range of motion, improved limb symmetry, less bone-tunnel widening, and improved patient-reported outcomes as compared to nonaugmented ACL procedures.1&nbsp;
 
 
Reference
1. Lavender CD, Schaver AL, Taylor S, et al. Anterior cruciate ligament reconstruction augmentation with bone marrow aspirate concentrate, demineralized bone matrix, and suture tape shows no difference in outcomes—but faster functional recovery—versus non-augmented anterior cruciate ligament reconstruction. Arthroscopy. Published online July 22, 2024.&nbsp;<a href="https://doi.org/10.1016/j.arthro.2024.06.042">https://doi.org/10.1016/j.arthro.2024.06.042</a>
 
The&nbsp;InternalBrace surgical technique is intended only to augment the primary repair/reconstruction by expanding the area of tissue approximation during the healing period and is not intended as a replacement for the native ligament. The&nbsp;InternalBrace technique is for use during soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation.

BioACL™ Technique

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

PCL injuries occur during sports-related activities or high-velocity, traumatic accidents. Indications for operative treatment of PCL tears include acute injuries, active young patients, and either isolated grade 3 tears or combined injuries, such as a grade 2 injury with posterolateral corner instability. 

Arthrex developed several techniques for isolated PCL injuries—including PCL inlay reconstruction, double-bundle PCL reconstruction, and the transtibial PCL RetroConstruction™ procedure—that can be combined with multiligament or posterolateral corner reconstruction.
Additionally, a comprehensive line of PCL reconstruction instrumentation is available for a variety of PCL reconstruction techniques, as well as autografts and allografts and single- or double-bundle options.

Posterior Cruciate Ligament (PCL) Reconstruction

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

TightRope ABS Button, Round, Concave 17 mm

AR-1588TB-17

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