Ligament and Tendon Repair Devices

Ligament and Tendon Repair Devices

Arthrex offers an extensive line of both soft tissue bone anchors from 2.2 mm to 5 mm as well as Tenodesis Screws from 3 mm to 9 mm in various materials (BioComposite, PLLA, PEEK, titanium). This offers surgeons operative flexibility when treating ligament or tendon pathology.

Arthrex offers an extensive line of both soft tissue bone anchors from 2.2 mm to 5 mm as well as Tenodesis Screws from 3 mm to 9 mm in various materials (BioComposite, PLLA, PEEK, titanium). This offers surgeons operative flexibility when treating ligament or tendon pathology.

View Scientific Evidence

PARS Achilles Midsubstance
SpeedBridge™ Implant System

PARS Achilles Midsubstance SpeedBridge™ Implant System

Open repair of acute Achilles tendon ruptures continues to remain controversial among surgeons as they weigh the tradeoffs of reduced re-rupture rates, improved calf strength, and increased return to activity against potential wound healing and infectious complications.¹ With the PARS Achilles Midsubstance SpeedBridge™ (AMSS) implant system, surgeons no longer have to compromise.
The benefits of the PARS AMSS system include:
• Percutaneous, knotless fixation using BioComposite SwiveLock^® anchors
• Augmentation of the repair using high-strength, low-profile FiberWire^® SutureTape sutures²
• Reproducible tensioning that eliminates the variability of knot tying
^References
^{1. Hsu AR, Jones CP, Cohen BE, Davis WH, Ellington JK, Anderson RB. Clinical outcomes and complications of percutaneous Achilles repair system versus open technique for acute Achilles tendon ruptures.}^{Foot Ankle Int.}^{2015;36(11):1279-1286. doi:10.1177/1071100715589632}
^{2. Arthrex, Inc. Data on file (LA1-00038); Naples, FL; 2021.}

Complete Plantar Plate Repair
System (CPR™)

Complete Plantar Plate Repair System (CPR™)

The majority of plantar plate injuries are treated with traditional lesser MTPJ rebalancing procedures, including sequential release of soft tissue, tendon transfers, metatarsal osteotomies, and temporary MTPJ pinning. These approaches, while quick and inexpensive, do not address the underlying issues of loss of toe purchase and the high incidence of reoccurrence often associated with performing an indirect repair. Direct repair of the plantar plate with Arthrex’s family of solutions delivers improved patient outcomes and higher patient satisfaction scores.
Arthrex’s continuous evolution in plantar plate repair has led to the development of a family of products capable of addressing any stage of lesser toe instability, from a partial plantar plate tear with mid-dorsal plane instability to a complete rupture and attenuation of the plantar plate with a crossover toe deformity. Below is the summary of our current offerings:
• CPR™ System With the Mini Scorpion™ and Pigtail Lasso Suture Passer
• CPR System With the Viper™ Suture Passer
• CPR System With the Forefoot InternalBrace™ Repair

Forefoot <em>Internal</em>Brace™ Ligament Augmentation
Repair Implant System

Forefoot InternalBrace™ Ligament Augmentation Repair Implant System

Arthrex has developed a comprehensive, completely disposable system for various augmentation procedures about the forefoot. Most commonly, this implant system can be used for crossover toe deformities of the lesser digits.
Features:
• All-in-One System – The implant system comes with 3 mm × 8 mm Tenodesis Screw implants, an oblong button, FiberTape^® and LabralTape™ sutures, drill bits, guidewires, and suture shuttling devices in a convenient, sterile package
• Knotless Repair Technique – Allows surgeons to create a strong, no-profile repair construct
• Multiple Technique Options – Implant system can be used to treat numerous pathologies about the forefoot
^The^Internal^{Brace 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}^Internal^{Brace technique is for use during soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation.}

<em>Internal</em>Brace™ Procedure for Brostrom Repair

InternalBrace™ Procedure for Brostrom Repair

Brostrom repair with the InternalBrace™ procedure provides additional fixation of the repaired ligament backdown to bone during the healing process, allowing early mobility during recovery and a quicker return to activity.¹ The InternalBrace 2.0 surgical technique provides surgical versatility with added size and material options. It comes with a talus offset guide that allows for reproducible anatomic placement of the talus SwiveLock^® anchor. Surgeons can drill, tap, and implant the SwiveLock anchor through the guide. The InternalBrace technique allows the surgeon to support the primary Brostrom repair of soft tissue to bone for lateral or medial ankle instability repair and can be used for chronic ankle injuries and revisions.
^Reference
^{1. Kulwin R, Watson TS, Rigby R, Coetzee JC, Vora A. Traditional modified Broström vs suture tape ligament augmentation.}^{Foot Ankle Int}^{. 2021;42(5):554-561. doi:10.1177/1071100720976071}
^The^Internal^{Brace 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}^Internal^{Brace technique is for use during soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation.}

PARS Achilles Jig System

PARS Achilles Jig System

Achilles tendon ruptures are common in the elite and recreational athlete and most often occur in the noninsertional region of the tendon complex. Most surgeons will elect to treat these injuries surgically, to lessen the risk for re-rupture,¹ while providing the opportunity for a quicker recovery and convenient rehabilitation.² Historically, open techniques have been used to repair the the rupture, but they can be complicated by wound-healing issues and infection.² This percutaneous and minimally invasive technique minimizes this concern.² PARS provides the opportunity for consistently reliable capture of the proximal and distal aspects of the Achilles tendon using color-coded SutureTape or FiberWire® suture.

The anatomically contoured guide is nondisposable, while the suture and passing needles come packaged in one convenient kit. The system provides the option to use transverse or locking sutures, or both. Using the locking option, a locked SutureTape or FiberWire suture can be incorporated on both ends of the ruptured tendon. This results in a stronger repair than just passing transverse sutures across the tendon like other minimally invasive devices on the market.³

The colored sutures offer a more organized approach to identifying and securing matched pairs. The healed tendon achieves a more natural contour, unlike the typical hypertrophic tendon resulting from open repair.⁴ This minimally invasive technique is ideal for middle-aged patients, where there may be a heightened concern for wound-healing issues.⁵

Advantages:

• Minimal incision reduces risk of wound complications²
• Provides the ability to create a locking stitch
• Specialized suture kits—8 different colored SutureTape or FiberWire sutures
• Easy suture management
• Reusable device with numbered, easy-to-follow steps
_References
_{1. Khan RJ, Fick D, Keogh A, Crawford J, Brammar T, Parker M. Treatment of acute achilles tendon ruptures. A meta-analysis of randomized, controlled trials.}_{J Bone Joint Surg Am.}_{2005;87(10):2202-2210. doi:10.2106/JBJS.D.03049}
_{2. Hsu AR, Jones CP, Cohen BE, Davis WH, Ellington JK, Anderson RB. Clinical outcomes and complications of percutaneous Achilles repair system versus open technique for acute Achilles tendon ruptures.}_{Foot Ankle Int.}_{2015;36(11):1279-1286. doi:10.1177/1071100715589632}
_{3. Demetracopoulos CA, Gilbert SL, Young E, Baxter JR, Deland JT. Limited-open Achilles tendon repair using locking sutures versus nonlocking sutures: an in vitro model.}_{Foot Ankle Int.}_{2014;35(6):612-618. doi:10.1177/1071100714524550}
_{4. Henríquez H, Muñoz R, Carcuro G, Bastías C. Is percutaneous repair better than open repair in acute Achilles tendon rupture?}_{Clin Orthop Relat Res.}_{2012;470(4):998-1003. doi:10.1007/s11999-011-1830-1}
_{5. Del Buono A, Volpin A, Maffulli N. Minimally invasive versus open surgery for acute Achilles tendon rupture: a systematic review.}_{Br Med Bull.}_{2014;109:45-54. doi:10.1093/bmb/ldt029}

Lisfranc Injury Fixation

Lisfranc Injury Fixation

Low energy, purely ligamentous injuries of the Lisfranc joint are difficult to detect and require a high index of suspicion due to their subtle presentation, particularly in athletes. Weightbearing radiographs, in combination with CT and MRI, may be required for proper diagnosis. Any diastasis greater than 2 mm is considered a positive for Lisfranc injury.

Traditional fixation methods using screws and/or plates provide a stable construct for the Lisfranc injury but may overconstrain the joint, resulting in the patient's inability to return to preinjury activity levels. Additionally, rigid fixation often requires a secondary surgery for hardware removal prior to full weightbearing and has the added risk of reduction loss.

Flexible fixation devices such as the 2.7 mm Knotless Mini TightRope® implant and Lisfranc Fixation System for InternalBrace™ repair overcome the shortcomings of rigid fixation and provide a strong^1,2 and reproducible construct to stabilize the Lisfranc joint.
^References
^{1. Arthrex, Inc. Data on file (APT-05278). Naples, FL; 2021.}
^{2. Arthrex, Inc. Data on file (APT-05279). Naples, FL; 2021.}

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