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Die in 5&nbsp;Ankerkonfigurationen erhältlichen Knee FiberTak-Anker verfügen über einzigartige Eigenschaften, die für die Behandlung von Pathologien im Kniebereich optimiert sind. Dazu gehören ein neu gestalteter, weicherer Ankerkörper für eine zuverlässige Entfaltung in hartem Knochen und leuchtende neue SutureTape-Farben für eine bessere Sichtbarkeit sowie ein einfacheres Fadenmanagement bei offenen Operationen. Der Ankerapplikator und das Lochvorbereitungsinstrumentarium haben eine kürzere Arbeitslänge, wodurch eine ergonomischere Ankerplatzierung viel näher an der Anatomie möglich ist.
Ferner ist das Instrumentarium als Einwegkit oder wiederverwendbares Zielinstrument, wiederverwendbarer Bohrer und wiederverwendbarer Punch erhältlich. Die Anker können mit dem Punch entweder in einen Bohrkanal oder ein Bohrloch eingebracht oder bei entsprechender Knochendichte sogar selbst gestanzt werden.
Eine Reihe von Implantaten ist für unterschiedliche Pathologien und Präferenzen der Operateur:innen verfügbar:
<ul>
 <li>Doppelter knotenloser Anker: Mit 2 vorkonvertierten, knotenlosen, spannbaren Schlaufen aus 1.3&nbsp;mm SutureTape; ideal für die LET- und ALL-Fixierung</li>
 <li>Hybrid-Anker: Enthält 1 vorkonvertierte, spannbare, knotenlose SutureTape-Schlaufe und ein gleitendes 1.3&nbsp;mm SutureTape mit atraumatischen Nadeln; perfekt für die Onlay-Rekonstruktion des Lig. patellofemorale mediale</li>
 <li>Doppelt geknoteter Anker: Mit 2 gleitenden 1.3&nbsp;mm SutureTapes mit atraumatischen Nadeln; eine großartige Option für alle Anwendungen, bei denen Knoten erforderlich sind</li>
 <li>Anker für die InternalBrace-Technik: Verfügt über 1 gleitendes 1.3&nbsp;mm SutureTape mit atraumatischen Nadeln und eine 1.7&nbsp;mm FiberTape®-Schlaufe mit flachem Profil, die zur leichteren Passage und Beladung zu einem einzelnen Ende gestanzt ist; revolutionär für die Seitenbandrekonstruktion mittels InternalBrace-Technik</li>
 <li>Button-Anker: Verfügt über 2 durchgehende Durchzugsverbindungen zur Fixierung unabhängiger Tension-Slide-Konstrukte; eine ausgezeichnete Option für MCL- und LCL-Tension-Slide-Konstrukte</li>
</ul>
Die InternalBrace-Operationstechnik ist ausschließlich zur Augmentation einer primären Naht&nbsp;/&nbsp;Rekonstruktion vorgesehen, bei der die Kontaktfläche des Weichteilgewebes während der Heilungsperiode vergrößert wird. Sie ist nicht als Ersatz für das native Band gedacht. Die InternalBrace-Technik wird bei Weichteilgewebe-zu-Knochen-Fixierungsverfahren eingesetzt und ist nicht für die Knochen-zu-Knochen-Fixierung zugelassen.

Asheesh Bedi, MD (Chicago, IL); Rachel M. Frank, MD (Denver, CO); Justin J. Mitchell, MD (La Crosse, WI); J. Lee Pace, MD (Plano, TX); and John William Xerogeanes, MD (Atlanta, GA), discuss the five Knee FiberTak® anchor configurations and their unique features, which are optimized for treating pathology around the knee.&nbsp;

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Knee FiberTak® Anchor: Our First All-Suture Anchor Platform Designed Specifically for the Knee

And when it comes to new technology or techniques, I'm looking at reliability, reproducibility and durability. I was immediately impressed with Knotless knee fiber tax. The ability for me to adjust and fine tune my tension, while not having any not present at all, was very attractive to me. We have a knotless tension anchor with tape. This allows us the opportunity to tension and then retension our repairs and reconstructions, resulting in a very reproducible and stable construct. In addition, the tapes have a variety of different vibrant colors. This has a number of advantages, but quite frankly, it makes it easier for me as a surgeon to see what I'm doing and to execute it correctly. You know. Certainly whenever you're using something new, you're a little bit daunted by is there going to be a big learning curve? But this is one that really was a relatively easy transition, with a lot of incremental benefit and being able to deliver the same benefits that I could with push lock technology, but with incremental benefits of tape based constructs that were pensionable. And it allowed me to customize my repair and construct for the pathology. In each patient. You want something that's easy, reproducible, and doesn't have a lot of downside. That's the beauty of this device is it's easy to deploy. This is easy. There's a hole, you stick it through it, you stick your graph through it, and you pull on it and it tightens it down. The knee NE fiber tech specifically has a more soft anchor body when we put it into hard bone, such as the patella. With such a low profile implant, we're minimizing our risk for iatrogenic injury. But our strength to resisting pull out and cyclical loading is outstanding. You're able to complete your repair or reconstruction within seconds, and you can rely on that reconstruction or repair. And then you can go back and retention that reconstruction or repair if needed. But now we have faster and more reproducible way to do our repairs and reconstructions, specifically in the knee. These knee fiber tech anchors can be used all over the knee. We have the MCL repair augmented reconstruction for the lateral collateral ligament extensor mechanism repair to include quadriceps tendon or patellar tendon repair. There are many different anchor configurations which allow for many different reparative and reconstructive procedures about the knee. Once you set your original tension, you can actually go on to alternative repair spaces and then retention to make sure you're getting anatomic reduction of tissues. So I think the variety and versatility that's available and give you the benefit of knotless technology does give you the confidence to feel comfortable using those in your practice. I'm certainly there, and I'm confident that other surgeons who make this transition will get there too.

This animation demonstrates the FiberStaple™ technique for an iliotibial band tenodesis using the Double Knotless Knee FiberTak® anchor.&nbsp;

Iliotibial Band Tenodesis Using the FiberStaple™ Technique and Double Knotless Knee FiberTak® Anchor

Introducing the Arthrex NE FiberTak platform. Suture anchors and instrumentation developed specifically for knee surgery. Featuring five new anchor variations with unique features designed to optimize the treatment of knee pathology with instrumentation. Ergonomically designed with a shorter working length, allowing surgeons to operate closer to the anatomy and aiding in a more precise drilling trajectory and anchor insertion. The double Knotless knee FiberTak features two pre converted tension tape loops, ideal for fixation of a modified la mer construct. An incision is made from approximately the lateral epicondyle to gerdy's tubercle to allow access to the iliotibial band. A one centimeter wide central strip of the IT band is released in line with the fibers of the IT band for a length of roughly eight centimeters, leaving the strip attached at its insertion at gerdy's tubercle. A SutureTape FiberLoop is used to whipstitch the proximal two centimeters of the harvested it band strip, and the needle is removed. Identify the Identify the anterior and posterior border of the fibular collateral ligament and make two parallel incisions. Expand the tissue plane deep to the FCL. Retrieve the whipstitch SutureTape FiberLoop tails and shuttle them proximally deep to the IT band, bringing the IT band graft under the fibular collateral ligament. Reflect the graft distally and prepare a bleeding bone bed. Insert the drill guide. Prepare a pilot hole using either a punch drill or by self-punching where appropriate. Insert the double knotless knee FiberTak through the guide until it contacts the back of the guide. Do not over impact. Remove the tab. Unravel the sutures and remove the inserter. Be careful not to inadvertently pull the tensioning strands. Place a probe inside the knotless loops and gently pull back to set the anchor. The whipstitch tails and graft are shuttled through both knotless loops. The knee is then placed in approximately 30 degrees of flexion. Pull the tensioning tail of the more proximal loop to cinch the graft down to bone. Gently reflect the it band. Graft distally through the second loop. Pull the second tensioning tail to cinch down the distal loop. The excess band tissue can be cut one centimeter distal to the fixation, or suture to the graft for extra reinforcement. Alternatively, the tensioning tails can be passed through the FiberStaple construct and tied to augment fixation.

Walter R. Lowe, MD (Houston, TX), demonstrates a lateral extra-articular tenodesis (LET) procedure using the FiberStaple™ technique. Dr. Lowe uses a Double Knotless Knee FiberTak® anchor to create a suture staple construct for fixation.&nbsp;
This new technique may eliminate risks such as hardware prominence from staples and graft laceration from screws and minimize the risk of tunnel convergence with the femoral ACL tunnel—challenges and complications commonly encountered with traditional LET techniques. The small, strong Double Knotless Knee FiberTak anchor helps minimize disruption to the surrounding anatomy and preserves more native bone. Its titratable functionality enables anchor deployment, graft tensioning, ROM evaluation, and if necessary, graft retensioning.

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

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LET Using a Double Knotless Knee FiberTak® Anchor in a FiberStaple™ Technique

Today we're going to show the FiberStaple technique of a modified la mer lateral extra articular Bio-Tenodesis and the equipment you see in front of you, sort of all you need to do this. So this is the guide. And you notice a much sort of a pistol handle, which is great, and a much shorter barrel, which will make it easy to hold up against the femur. And then this is the self-punching double loaded knotless knee FiberTak with the blue and black sutures, and then A26 drill for hard bone to pre-drill it. We'll prepare the graft with the mini FiberLoop you see up here, and then that's really all we need to move on and do the lateral extra articular tenodesis. Today we're going to show the FiberStaple modified technique of a lateral intra-articular Bio-Tenodesis. This is a left knee as you can see here. Sort of drawn out. Typical incision for me is sort of from gerdy's up proximal in this range here to where I can not only see the whole IT band, but sort of follow it underneath the skin down to Gertie. So I know my real link. So the typical incision is going to be something like this. Which is six centimeter, seven centimeter incision. The first landmarks that we want to identify are the IT band. You can see here in the interval between the IT band and the biceps femoris. You see here. Because we want to preserve these more posterior fibers of the IT band or these Kaplan fibers, as they're an important part of lateral stability. I like to come about a centimeter off of this interval between the IT band and the biceps femoris, and make my inferior cut first. And then I'll follow it with about a centimeter width of the more superior cut. And then distally we'll just extend this sort of pointing right down towards Gurdies. This is one of the little rulers that I've cut off to show just eight centimeters, and I really think that's the length we want to get to do this. Double FiberTak technique. Take that down to Gurdies for the IT band is. You can see my IT band harvest is up at about that eight centimeters. You can stick this down and up, but I find it really helpful to shorten this to get that measurement. And for this part I'll typically put an Army retractor up approximately and then Metz back. You know, with this exposed like this, I just reach up and make the proximal cut in the IT band and that we're going to release, and then we'll just dissect it. Approximately to free it up. And now we'll switch this to down here. And now we have our IT band ready for suture. And then using this mini FiberLoop just to prepare this where we get, you know, probably a couple of centimeters of grasp of it. Here's the IT band part of the Lat that's been sutured with just the mini FiberLoop tape and ready to pass. So it's always important to draw out the path of the lateral collateral ligament. And we just want to make a vertical incision just anterior to it just through the capsular tissue and just posterior to it. And then I find coming from anterior to posterior to start with to get your path. So with this hemostat pass through you can just pass a suture if you want. From here, a loop suture to pull it through. I like to follow it with a hemostat from the other direction, because it lets me spread sort of both entrances pretty symmetrically. Then we'll just feed the sutures of our graft. Passing a suture is a little easier, but this has made it easier for me to get the IT band to pass freely underneath the lateral collateral. And so here you kind of want to get an elbow, have it dunked down underneath it and then should just pull right through. So now this is the part of the let the IT band has been passed underneath the lateral collateral. Next we're going to expose the distal femur. I've just done that with a knife. I'll typically do that with cautery. One point to make here is you definitely when you close you want the tourniquet down. Because if you get into this lateral geniculate out here. You can see some significant bleeding afterwards. And so you want to make sure all that's controlled. So very important when you're exposing this with cautery to be watchful. And then I'm exposing the distal femur just down to the turn into the metaphyseal part of the femur. And that's going to be the location just above that posterior part of the femur where we're going to put the, the lead. And I'll typically prepare the bone, be able to see it, all of that with a cob. And then we'll identify our spot with the c-arm and then proceed from there. So this is now the knee FiberTak guide. This is a 2.6 drill we showed earlier that will take up and just drill. Now we're going to insert the double loaded knee Knotless FiberTak that we pre-drilled. And then this just, you know, hammers into the hub. A FiberTak set. We're going to put a probe in both loops and just make sure that anchor is set. And these loops are already passed. We don't have to use another suture. It's always good to kind of use the same orientation so we know what we're doing. And so with this we're going to pass our IT band through black. And then through blue. And so we'll set blue first and I'll come out 30 degrees. And all you do is pull and set. Then once we've set the blue loop, we're going to pull the IT band down and set the black loop. We're going to set the final tension or the tight tension with our tensioning handles, which you can see here. This lets you tension it tightly. Same thing with the black is the final one tension there. And so here you can see blue well tensioning down to the femur and looped underneath that. And then the black tensions both the deep part and the more superficial part of that turn of the it band together and down to the femur. And then if you want for additional fixation, you can take the FiberLoop, put a free needle on it and just sew it to the IT band just back behind the fibular collateral ligament.

Gautam P. Yagnik, MD (Miami, FL), demonstrates an onlay MPFL reconstruction using Knee FiberTak® hybrid anchors in the patella and a FastThread™ interference screw on the femur.&nbsp;

Onlay MPFL Using Knee FiberTak® Hybrid Anchors

Hi, this is Gautham Yagnik from Miami, Florida. Today I'm going to demonstrate the Mpfl inlay reconstruction technique. Before we get into our procedure, we're going to highlight some of the instrumentation and implants that we're going to be using. We're going to use the new knee FiberTak hybrid anchors that have both a knotless mechanism as well as free sutures. We also have our drill guide and our 2.6mm drill. We'll also use our mini SutureTape FiberLoop as well as FiberSnare. We'll also be using a six millimeter FastThread interference screw. We have our nitinol wire, our template to help identify shadows point on the medial side of the femur, our beef pin and reamer. The first thing I'll do is expose the medial border of the patella. So you can kind of translate the patella slightly medially here. And you can see we've drawn out our incision. So I'll take a take a blade and we'll cut right down through the skin and soft tissues. Subcutaneous tissues, right down onto the patella. And then you can see now that we've, we've gotten down to the, to the retinaculum here that lays over top of the patella. So now at this point we'll incise sharply right on the medial border of the patella through this retinaculum. So once we've exposed the medial border of the patella here we've incised the retinaculum. And we're looking right now at that upper one half of the patella, the medial border here. For the next part of the procedure, we'll go ahead and place our FiberTak anchors prior to placing our anchors. We like to create a bone trough on the medial side of the patella. We'll use our Miss Burr here to create a nice bleeding bed surface to facilitate tendon and bone healing. So now we're going to go ahead and prep the medial side of the patella here. [00:01:58] Create a nice trough. So we've created our our trough here for our graft. We now have our medial border exposed. We're going to go ahead and place our first anchor. So after we prepared the medial side of the patella the medial border of the patella, we're going to place our first anchor proximally. So bring our guide down. [00:02:25] And we're going to drill. And then we like to bring this drill in and out at least a second time here just to make sure we can fully seat our anchor. Then I'll hold the guide in place and we'll place our anchor right through the guide. Bring it down until it's contacting bone and then with firm counter pressure will mount this into place. So after we've we removed our anchor inserter, we can see the different sutures that we have here. We have our black suture tapes that are sliding sutures that will also help us to set the anchor. And so these are preloaded here with with needles to help us for our retinacular repair invocation at the end of the procedure. And then we'll place these to the side. Then you can see our SutureTape loop that we already have that's pre converted for our knotless mechanism. And so we'll leave this nice and long now. So we put these sutures off to the side. And we'll place our second anchor anywhere between 10 and 15mm distal to where we placed our first anchor. We'll go ahead here and place our second anchor. So we'll bring our drill in. Once again we're holding firm counter pressure. We're going to go and cycle that drill. Bring it all the way down and down again just to make sure. That's good. Bring that out. And then again, through the drill guide, we'll place our second anchor again. You need someone to your assistant to really hold firm counter pressure here. We've removed the inserter. And once again, we can use our our free sutures here to kind of toggle and seat our anchor. Make sure that it's firmly seated within the patella. We'll move these sutures out of the way. And once again we have our loop that's already pre converted for our knotless mechanism. And again we're not going to tension these down too much. But I will give a little pull here just to make sure that this slides well. So we know we have both for our anchors seated. We have both of our knotless mechanisms that are pre converted ready to go to accept our graft. So now we're bringing our graft onto the field. You can either use autograft or allograft gracilis or semitendinosus. Just depends on the size of the patient. The nice part about this procedure is there's really no graft prep that's needed. I'll measure the graft to approximately 220mm. So now we'll go ahead and slide this graph through the pre converted knotless mechanisms. And then we use our center mark as the position that we're going to place our graft against the patella. We've laid our graft against the medial border of the patella. We put our mark between the two anchors. And then we'll go ahead and fix the proximal portion of the graft first. So I'll go ahead and start to tension that down. And you can see how easily that goes. And the SutureTape really compresses and secures that graft to the medial side of the patella very nicely. So once I do that and I'm happy with that position, I'll go to my distal anchor. And I'll repeat this same step here. And once again just taking this tension out and locking this graft, securing it really nicely to the medial border of the patella. And then I can go back and get any little extra bit of creep out of this system and really make sure that this graft is really firmly secured to the medial border of the patella. Once we finish that aspect of it, we can bring our graft over and we can see that we have at least about 10 to 15mm of graft that are approximated against the medial border of the patella. And just by adding some gentle medial pressure to our graph, you can see how much control we have over the whole patella. So it's a really, really nice way to fix your graft. So now we're going to sew the two ends of our graft tales together using this new mini SutureTape FiberLoop. So pierce the graft in the center to get it started here. Going to lock our first limb in here, bring it back through. And for our last loop. We'll try to lock it here just so we have this really well secured. So now we have both tails sutured together. We have our graft fixed on the medial border of the patella. And so we're ready to move to the femur. So to identify our femoral fixation point we'll use fluoroscopy. We'll get a perfect lateral and we'll identify shadows point on the medial side of the femur. Here you can see on the fluoroscope image us identifying this isometric point. So once we've identified shadows point on the medial side of the femur which is just slightly proximal and a little posterior to the medial epicondyle. So between the medial epicondyle and the adductor tubercle is the point that we've identified on fluoroscopy. So we made our incision. We dissected down. We're going to go ahead and place our pin. Pen. So field, make sure I'm in that right spot and then we'll go ahead. And you want to angle your hand slightly proximal and anterior to avoid the notch. So we like to keep the knee at this point in 30 degrees of flexion. We've placed our pin. And now we're going to Overeem with our six millimeter reamer. And then I'll usually take this all the way to the far cortex but not through the far cortex. Just so we have as much tunnel length as possible so we don't bottom out on our graft. So once we've done that, we'll go ahead and put in a nitinol wire parallel to our our beef pin. That way we know exactly where our tunnel is. And then we'll go ahead and pass our graft from the patella down to the medial side of the femur. So I like to use a curved Kelly here through our little path that we created. We're staying extra articular but deep to the soft tissues. You can see our Kelly coming down through. And this is where we'll bring our FiberSnare onto the field. Pinch that and we'll bring that back up to the patella. We'll use our FiberSnare here to take the tail ends of our patella. Graft. And we're going to shuttle that down to the medial side to our tunnel. So once we've brought that down again holding a little bit of counter pressure on our graft, bringing our sutures down first. So that way we make sure that there's no soft tissue bridge. And you can see we can bring our graft right parallel to our, our beef pen. So now we have our graft tales loaded into the beef pen. And now we're going to go ahead and pass those into our tunnel. And I'll use a freer here just to keep a little counter pressure on the graft. And until we're ready to dock it into the tunnel. And so then we'll go ahead and position the graft right at the opening of the tunnel. And then we'll dock that graft into our tunnel. And you can see that. So now we need to set the tension for our graft. The one thing we want to avoid here when we're doing an mpfl reconstruction is over medicalizing the patella or over constraining the patella. So now that we've passed our graph, we have our guidewire in place for our screw. We're now going to go ahead and set the position of the patella. So we'll place the knee in 30 degrees of flexion. And then kind of translate the patella until I feel that perfectly centered position where I line up the lateral border of the patella with the lateral aspect of the trochlear groove. And that's where I'm going to set the patella. I'm going to have my assistant hold a little pressure and set the kneecap. Hold it right in that position. And he's actually placing a slightly laterally directed force so we So we don't over idealize or over constrain the patella. And we have some tension on our sutures. So we're going to bring in our FastThread screw now over top of of our nitinol wire. And now that we have everything set in position, we're going to go ahead and fix our graft in place. And the nice thing about this screw is you don't need to tap and fixate our graft. So I'll go down and put my finger until I feel that our screw is completely flush and buried within our tunnel. Go ahead and remove our screw and our nitinol wire, and we can go ahead and range the knee to make sure that we're happy with the position of our of our patella, so we can see that the graft is now well fixed on the patella. We have nice tension on our graft. We have an over constrained or over medium size our patella, because the mpfl is really just a check rein to prevent lateral subluxation or translation of our patella. And then here we can see that the graft is well fixed in the femoral tunnel as well. So we can use all our sutures from our knee FiberTaks to help close our retinaculum. So we use a free needle here with our repair strand or our tensioning strand. We can go ahead and pass that through the retinaculum. And for this I'll do a horizontal mattress using these sutures. So we'll pass this through and then we'll load. The proximal suture. Do the same thing here with our proximal suture. So now we have a horizontal mattress stitch that we can use. We use our sutures from the distal anchor to close our distal retinaculum in a simple fashion. And then we can go ahead and use our sutures from our proximal anchor to close the proximal aspect. So now we've passed all our sutures. So we have our proximal sutures passed on either side of the retinaculum up here. You can see how nicely that will approximate the tissues. We have our distal sutures passed here. And we're going to tie our horizontal mattress using our tensioning sutures. So I'll go ahead and tie that and we'll go proximal to distal. And you can use these sutures. Additionally if you have some redundant capsule or some redundant tissue if you want to imbricate some of the tissue. And so you can see that we get a really nice closure of the soft tissues over top of our mpfl reconstruction.

Brian J. Cole, MD, MBA (Chicago, IL), introduces the Knee FiberTak® anchor platform and explains how the features of the Knee FiberTak implant benefit patients.&nbsp;
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.&nbsp;

Introduction to the Knee FiberTak® Anchor Platform

Today I'm excited to introduce the new Arthrex NE FiberTak anchor platform of suture anchors and instrumentation developed specifically for knee surgery. Over the next few minutes, I will review the five new anchor configurations, highlighting their unique features that may optimize the treatment of knee pathology. The instrumentation, offered in both single use and reusable formats is ergonomic, with a shorter working length, allowing surgeons to operate closer to the anatomy and aids in a more precise drilling trajectory with anchor insertion. Knee FiberTak implants use a redesigned anchor body with a softer, less dense material that enables easier anchor insertion in hard bone, as well as having a more consistent bunching effect of the anchor material in softer bone. The anchor inserter has also been optimized to be more rigid, allowing the ability to self-punching where appropriate, but also to drill or punch a pilot hole with an awl, depending upon the bone quality and anatomy, starting with the double knotless knee FiberTak. This implant features two pre converted double knotless loops, eliminating the step of shuttling that otherwise converts the knotless loop mechanism. This implant features knotless double loops made of SutureTape. The loops are constructed of 1.3mm suture tapes with vibrant colors to improve visualization and suture management. For me, this implant has been particularly useful when I perform an let us procedure specifically using the FiberStaple technique. Here we see how quickly and easily the double knotless FiberTak is self-punching through the pistol grip guide. The IT band strip is shuttled through the pre converted tape loops, and with the knee and the appropriate amount of flexion, the first loop is provisionally tensioned. Now I like to range the knee to ensure appropriate construct tension. And then when I confirm this correct tension, I fully tension the first loop. The IT band strip is then reflected back distally through the Through the second preconcerted loop and tension down to complete the FiberStaple construct if desired. I have the ability to pass the tensioning tales through the graft and tie for additional fixation. The next anchor I want to showcase is the hybrid Knotless ni FiberTak. It's called the hybrid because it includes options for creating both knotless and knotted points of fixation. The hybrid features one Knotless pre converted 1.3mm blue SutureTape loop, and an additional black sliding 1.3mm SutureTape was swaged on curved needles. I perform a large volume of mpfl reconstruction procedures, and I have recently transitioned to the onlay graft fixation technique on the medial patella. The hybrid ni FiberTak instrumentation simplifies the implantation, making it easier to stabilize the patella and the drill guide during implantation. Once my patella ni FiberTaks are placed, I can shuttle the mpfl graft through the pre converted loops and then very easily and precisely tension the graft to the medial aspect of the patella. Another feature that I like is that these sliding suture tapes are perfect for performing an imbrication or retinacular closure, or even augmenting my Mpfl Graf fixation for circumstances where knot tying is required, the double loaded knee FiberTak is a great option. I have found that the blue and black colored SutureTape strands are easy to differentiate, even in a deep, bloody environment. Additionally, the 1.3mm SutureTape creates a stronger, more low profile knot that is less prominent and less likely to cause irritation to the patient. These double knotted FiberTaks have become my go to for joint line fixation in distal MCL, avulsions and reconstructions, as well as anytime I need to spot weld fixation with a suture configuration that includes a knot. This is the NE FiberTak for the internal brace technique. This implant features a FiberTape suture that is swaged down to a single tail for easy suture management, as well as a sliding 1.3mm SutureTape with swaged on needles. The FiberTape suture can be used for an internal brace technique, but can also be used for a construct where a SpeedBridge type repair is desired, whether in the knee, ankle, elbow, or elsewhere. Over the last several years, we've learned more about the benefits of the internal brace technique to augment and protect our soft tissue repair and reconstruction constructs. Like many of my colleagues from around the world, I've adopted the internal brace technique into several procedures that I commonly perform, and notably, MCL repairs. This implant allows me to utilize a minimally invasive approach and a soft body anchor to create a single point of fixation for the primary repair with FiberTape augmentation. The swages on FiberTape limb makes suture passage simple, and can be easily loaded into a 3.9 SwiveLock anchor, or even a knee FiberTak button for TensionLoc distal fixation. This is the NE FiberTak button, similar to the FiberTak button for biceps tenodesis. This implant features two passing links loaded in opposing directions that allow the surgeon to independently prepare a suture construct in tissue using their choice of suturing method, and then pass the two whipstitch suture limbs through the NE FiberTak button in a tension slide construct. The surgeon can then tension the limbs individually to reduce the tension down to the predetermined point of fixation. I found this technology extremely beneficial in treating distal MCL avulsions, as I can create a robust locking Krakow construct that is more easily tensional than with traditional sliding suture anchor fixation. Beyond the conventional approach of standard anchor implantation, I found tremendous value in the ability to unload NE FiberTaks from their metal inserter and shuttle them in a trans osseous fashion, in circumstances where the bone quality may be questionable. For example, placing anchors in or around the fibular head. I like that I can drill a small diameter intraosseous tunnel and shuttle the sutures from my knee, FiberTak in a retrograde manner, and not have to worry about the anchor pulling through the cortex or creating a bony defect. Alternatively, for extensor mechanism injuries like quadriceps tears, placing double knotless knee FiberTaks at the inferior pole of the patella and shuttling the loops and tensioning the tails proximally allows me to create independent suture configurations in the quadriceps tissue with any diameter suture I choose. I can then link through the knotless loops, allowing for intentional and unintentional repair. Construct the knee FiberTak anchor platform is not only the first anchor designed specifically for the knee, but also allows me to treat virtually any pathology around the knee that I might encounter on a day to day basis in my operating room.

Knee FiberTak® Anker

Knee FiberTak® Anker