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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Endobuyton previous studies showed a positive correlation between a malpositioned EndoButton and a higher rate of button migration. Although they suggested that an tehcnique angle of knee flexion was more likely to result in soft-tissue interposition before flipping, they did not describe any complications resulting from the failure of flipping. Journal List Arthrosc Tech v. In general, suspension of the EndoButton over soft tissue, such as the ITB, was weaker than that on the femoral cortex.

A disadvantage of using our arthroscopic sufgical is the potential risk of compartment syndrome after excessive introduction of fluid in the LF portal. 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 right knee.

Fortunately, the patient had no ACL instability. However, arthroscopic ACL reconstruction is more technically complex, and inexperienced surgeons may have difficulty identifying the interposed soft tissue and EndoButton.

C The Vulcan probe arrowheadintroduced through the second LF portal, can survical the interposed soft tissue surrounding the EndoButton arrow.

Postoperative Rehabilitation A standardized postoperative protocol is implemented for each patient. National Center for Biotechnology InformationU.

Endobutton button endoscopic fixation technique in anterior cruciate ligament reconstruction.

Knee Surg Sports Traumatol Arthrosc. This technique requires careful cleaning of the soft tissue over the lateral cortex of the femur. Discussion This Technical Note presents an arthroscopic technique that successfully removes interposed soft tissue between the EndoButton and the lateral aspect tefhnique the femoral cortex and reduces EndoButton migration from the lateral aspect of the femoral cortex of the knee.

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Some surgeons have recommended the use of intraoperative fluoroscopy to assess the position of the button and its relation to the femoral cortex. The techniques allows direct visualization of the reduction of the migrated EndoButton.

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Support Center Support Center. Pediatric anterior cruciate ligament femoral fixation: Find articles shrgical Hajime Utsunomiya. There is a risk of damage to the EndoButton loop by using the Vulcan. Do adjustable loops lengthen?

Reduce the migrated EndoButton to surglcal proper position, and fit the EndoButton to the lateral cortex of the knee by pulling the graft on the tibial side. 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.

There is also a risk of damage to the EndoButton loop by using the Vulcan. Abstract Suture button—based femoral cortical suspension constructs of anterior cruciate ligament grafts can facilitate a fast and secure fixation.

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. There is a paucity of available literature regarding how to best remove interposed soft tissue and reduce the position of the EndoButton. Several studies have shown that EndoButton malpositioning over the soft tissue around the knee induces either tissue irritation or migration of the button.

ENDOBUTTON CL ULTRA | Smith & Nephew – US Professional

The advantages of this arthroscopic technique include surgicsl incisions and direct visualization that can help remove any soft-tissue interposition and reduce a migrated EndoButton. Published online Oct Seating of TightRope RT button under direct arthroscopic visualization in techniwue cruciate ligament reconstruction to prevent potential complications. Make an LF portal by longitudinally extending the guide pin incision.


Report of two cases. Click here to view. A Vulcan probe can also be inserted through the same portal to help manipulate and fit the EndoButton into the proper position at the lateral cortex of the femur by pulling the graft on the tibial side Fig 2 D and E.

In addition, there is a small possibility of injury to the lateral superior genicular artery. Endobuton author disclosure forms: Supplementary Data Video 1: An unidentified pitfall of Endobutton use: An arthroscope is inserted into the LF portal to evaluate for EndoButton migration from the lateral aspect of the femoral cortex Fig 2 A and B. Surgical Technique The described ACL reconstruction technique was arthroscopically performed by the senior surgeon. There appears to be a short recovery time, which is especially beneficial for athletes who must quickly recover back to their preinjury activity level.

Footnotes The authors report the following potential conflict of interest or source of funding: The arrow shows the EndoButtons of the anteromedial and posterolateral graft.

A systematic review of randomized controlled trials. However, this technique requires a longer intraoperative time and a relatively higher level of surgical skills that may limit its use to more experienced surgeons. Another potential complication is lateral extravasation because this technique is performed in the extra-articular space. D Removed soft tissue beneath migrated EndoButton arrow. This minimally invasive approach assists surgial the correction of the migrated EndoButton to the femoral cortex to the proper position.

Am J Sports Med.