ACL Reconstruction

ACL Reconstruction

Quad Tendon Autograft ACL Reconstruction

Quad Tendon Autograft ACL 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}

BTB Autograft ACL Reconstruction

BTB Autograft ACL Reconstruction

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.

Hamstring Autograft ACL Reconstruction

Hamstring Autograft ACL Reconstruction

Arthrex offers 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^® 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 facilitates 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.

Allograft ACL Reconstruction

Allograft ACL Reconstruction

For primary and revision ligament repairs and reconstruction procedures, a variety of tendon allografts—including a wide portfolio of presutured tendons—are available. Allograft tendons provide many benefits compared to autograft tendons in reconstructive procedures, including less donor-site morbidity,^1,2 fewer incisions, shorter operative time,^1,2larger and predictable graft sizes,² and decreased postoperative pain and stiffness.²

Choose from sterile or aseptically processed tendons. Sterile tendons from our tissue bank alliance partners are rendered sterile without biomechanical or biochemical changes to the tissue.

Presutured constructs are an off-the-shelf solution requiring minimal preparation time while providing surgeons with a high-quality, consistent, sterile, and strong allograft tendon.
References
^{1. Edgar CM Zimmer S, Kakar S, Jones H, Schepsis AA. Prospective comparison of auto and allograft hamstring tendon constructs for ACL reconstruction.}^{Clin Orthop}^{Relat Res.}^{2008;466(9):2238-2246. doi:10.1007/s11999-008-0305-5}
^{2. Greenberg DD, Robertson M, Vallurupalli S, White RA, Allen WC. Allograft compared with autograft infection rates in primary anterior cruciate ligament reconstruction.}^{J Bone Joint Surg Am}^{. 2010;92(14):2402-2408. doi:10.2106/JBJS.I.00456}
^{Disclaimer: Allograft product offerings depend on country approval and product availability.}

BioACL™ Technique

BioACL™ Technique

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

^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^{. 2025;41(5):1496-1508.}^{https://doi.org/10.1016/j.arthro.2024.06.042}

_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.}

Revision ACL Reconstruction

Revision ACL Reconstruction

It is estimated that between 1.8% and 10.4% of patients who undergo ACL reconstruction will require a revision.¹ Addressing tunnel widening and restoring previously malpositioned tunnels can be challenging, sometimes requiring a two-stage approach.²The Cannulated Bone Dowel Kit offers surgeons a simplified solution to effectively address these issues.
Allograft bone dowels act as a biologic scaffold to provide an immediate structural architecture and promote osseous integration. The bone dowels can be soaked in platelet-rich plasma (PRP) or bone marrow aspirate to provide autologous cells and growth factors that facilitate graft incorporation.
Additionally, the press-fit nature and structural integrity of the bone dowels provides surgeons the option to take a single-stage approach in cases where no more than half of the failed tunnel is violated. Favorable outcomes have been reported for patients undergoing single-stage ACL reconstruction using allograft bone dowels.³
Along with allograft bone dowels, the FlipCutter® III drill is particularly advantageous in setting a revision ACL reconstruction. The all-in-one adjustable guide pin and reamer allow surgeons to precisely debride remnant tissue and maximize residual bone stock during tunnel preparation.
^References
^{1. MARS Group, Ding DY, Zhang AL, et al. Subsequent surgery after revision anterior cruciate ligament reconstruction: rates and risk factors from a multicenter cohort.}^{Am J Sports Med}^{. 2017;45(9):2068-2076. doi:10.1177/0363546517707207}
^{2. Richter DL, Werner BC, Miller MD. Surgical pearls in revision anterior cruciate ligament surgery. When must I stage?}^{Clin Sports Med}^{. 2017;36(1):173-187. doi:10.1016/j.csm.2016.08.008}
^{3. Werner BC, Gilmore CJ, Hamann JC, et al. Revision anterior cruciate ligament reconstruction: results of a single-stage approach using allograft dowel bone grafting for femoral defects.}^{J Am Acad Orthop Surg}^{. 2016;24(8):581-587. doi:10.5435/JAAOS-D-15-00572}

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