The surgical technique of Endobutton (Acufex Microsurgical, Inc,. Mansfield, MA) button fixation for anterior cruciate ligament reconstruction is described. TECHNIQUE FOR ACL RECONSTRUCTION USING THE. ACUFEX DIRECTOR DRILL GUIDE AND ENDOBUTTON CL. 데 . A doubled surgeon’s knot is used. The surgical technique of Endobutton (Acufex Microsurgical, Inc, Mansfield, MA) button fixation for anterior cruciate ligament reconstruction is described.
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Confirm the migration of the EndoButton to the lateral cortex of the knee through the LF portal.
Intra-articular detachment of the Endobutton more than 18 months after anterior cruciate ligament reconstruction. An ipsilateral semitendinosus and gracilis autograft is used in every case. Second-generation, no-incision anterior cruciate ligament reconstruction. A systematic review of randomized controlled trials. Three femoral techhique devices for anterior cruciate ligament reconstruction: Suture button—based femoral cortical suspension fixation of anterior cruciate ligament ACL grafts can facilitate a fast and secure graft fixation for ACL reconstruction.
A probe can be inserted through the same portal to help manipulate the EndoButton into the proper position at the lateral cortex of the femur by pulling the graft on the tibial side. Excessive introduction of fluid may increase the risk of compartment syndrome. National Center for Biotechnology InformationU. The described ACL reconstruction technique was arthroscopically performed by the senior surgeon. Please review our sirgical policy. There appears to be a short recovery time, which is especially beneficial for athletes who must quickly recover back to their preinjury activity level.
Fortunately, the patient had no ACL instability. The effect of cortical button location on its post-operative migration in anatomical double-bundle anterior cruciate ligament reconstruction. Find articles by Hajime Utsunomiya.
Report of two cases. Surgical Technique The described ACL reconstruction technique was arthroscopically performed by the senior surgeon. Author information Article notes Copyright and License information Disclaimer. Footnotes The authors report the following potential conflict of interest or source of funding: Our technique cannot be applied in the case of a migrated EndoButton resulting from malpositioning of the femoral bone tunnel.
The techniques allows direct visualization of the reduction of the migrated EndoButton.
Weakening of femoral fixation before graft integration might cause loosening of the reconstructed ACL and failure of the ACL tecgnique. A disadvantage of using our arthroscopic technique is the potential risk of compartment syndrome after excessive introduction of fluid in the LF portal.
Endobutton button endoscopic fixation technique in anterior cruciate ligament reconstruction.
The arrowhead indicates the Vulcan probe. 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. Physical therapy, consisting of exercise without resistance, to improve range of motion is initiated immediately after surgery.
Reduce the migrated EndoButton to the proper position, and fit the EndoButton to the lateral cortex of the knee by pulling the graft on the tibial side. Switch the shaver to a Vulcan probe to remove any interposed soft tissue beneath the EndoButton. We describe an arthroscopic technique for making femoral tunnels through the outside-in method that reduces the migration of the EndoButton through a lateral femoral portal. Find articles by Angela Chang. Some surgeons have recommended the use of intraoperative fluoroscopy to assess the position of the button and its relation to the femoral cortex.
ENDOBUTTON CL ULTRA | Smith & Nephew – US Professional
Seating of TightRope RT button under direct arthroscopic visualization in anterior cruciate ligament reconstruction to prevent potential complications. Postoperative anteroposterior radiograph of a right Rt knee showing reduced EndoButton to lateral aspect of femoral cortex. Suture button—based femoral cortical suspension constructs of anterior cruciate ligament grafts can facilitate a fast and secure fixation. There is a paucity of available literature regarding how to best remove interposed soft tissue and reduce the position of the EndoButton.
A standard arthroscopic examination is performed through anteromedial and anterolateral portals. Do adjustable loops lengthen? Knee Surg Sports Traumatol Arthrosc.
This minimally invasive approach assists in the correction of the migrated EndoButton to the femoral cortex to the proper position. Several techniques have been proposed to ensure accurate placement of the EndoButton and lessen the probability of malpositioning. Associated Data Supplementary Materials Video 1 After passage of the anterior cruciate ligament ACL graft through the tibial tunnel, the position of the EndoButton is confirmed by fluoroscopy after the EndoButton is felt to be flipped in a suegical knee.
E The position of the EndoButton arrow is fixed to the lateral aspect of the femoral cortex. Am J Sports Med. Open in a separate window. They determined that migration of the EndoButton was more common with the presence of soft-tissue interposition and clinical outcomes were unaffected by migration and soft-tissue interposition. Introduce tedhnique shaver through another LF portal to clean up the soft tissue surrgical the EndoButton.