InternalBrace™ Technique

Proven to be efficacious1 and applicable in various ways throughout the knee, the InternalBrace technique helps prevent excess range of motion during the healing phase and may reduce the chances of secondary injury.2,3

When used in ACL reconstruction, the InternalBrace technique helps protect against various modes of failure, including creep and irreversible stretch, traumatic tearing, and slippage of the tendon-bone interface.4,5 The InternalBrace technique may also help protect small and vulnerable hamstring ACL reconstruction grafts from these modes of failure.4,5

Additionally, the InternalBrace technique can help augment collateral ligament repairs and reconstructions and provide improved biomechanics, including greater stiffness and maximum load.6 Anatomic repair with augmentation may allow for early treatment using native tissues, while still providing a biomechanical environment conducive to early rehabilitation and motion.2 Compared to reconstruction techniques, there are several additional benefits of augmenting collateral ligament repairs, including smaller drill holes and implants, no harvest-site morbidity with allograft, and no risk of tunnel convergence in multiligament procedure.

References

1. Bodendorfer BM, Michaelson EM, Shu HT, et al. Suture augmented versus standard anterior cruciate ligament reconstruction: a matched comparative analysis. Arthroscopy. 2019;35(7):2114-2122. doi:10.1016/j.arthro.2019.01.054

2. Mackay GM, Blyth MJ, Anthony I, Hopper GP, Ribbans WJ. A review of ligament augmentation with the InternalBrace™: the surgical principle is described for the lateral ankle ligament and ACL repair in particular, and a comprehensive review of other surgical applications and techniques is presented. Surg Technol Int. 2015;26:239-255.

3. Smith PA, Bley JA. Allograft anterior cruciate ligament reconstruction utilizing internal brace augmentation. Arthrosc Tech. 2016;5(5):e1143-e1147. doi:10.1016/j.eats.2016.06.007

4. Bachmaier S, Smith PA, Bley J, Wijdicks CA. Independent suture tape reinforcement of small and standard diameter grafts for anterior cruciate ligament reconstruction: a biomechanical full construct model. Arthroscopy. 2018;34(2):490-499. doi:10.1016/j.arthro.2017.10.037

5. Bedi A. Editorial commentary: buckle up surgeons: “safety belt” reinforcement of knee anterior cruciate ligament reconstruction grafts. Arthroscopy. 2018;34(2):500-501. doi:10.1016/j.arthro.2017.12.009

6. Arthrex, Inc. LA1-00086-EN_B. Naples, FL; 2018.

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.

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Proven to be efficacious1 and applicable in various ways throughout the knee, the InternalBrace technique helps prevent excess range of motion during the healing phase and may reduce the chances of secondary injury.2,3

When used in ACL reconstruction, the InternalBrace technique helps protect against various modes of failure, including creep and irreversible stretch, traumatic tearing, and slippage of the tendon-bone interface.4,5 The InternalBrace technique may also help protect small and vulnerable hamstring ACL reconstruction grafts from these modes of failure.4,5

Additionally, the InternalBrace technique can help augment collateral ligament repairs and reconstructions and provide improved biomechanics, including greater stiffness and maximum load.6 Anatomic repair with augmentation may allow for early treatment using native tissues, while still providing a biomechanical environment conducive to early rehabilitation and motion.2 Compared to reconstruction techniques, there are several additional benefits of augmenting collateral ligament repairs, including smaller drill holes and implants, no harvest-site morbidity with allograft, and no risk of tunnel convergence in multiligament procedure.

References

1. Bodendorfer BM, Michaelson EM, Shu HT, et al. Suture augmented versus standard anterior cruciate ligament reconstruction: a matched comparative analysis. Arthroscopy. 2019;35(7):2114-2122. doi:10.1016/j.arthro.2019.01.054

2. Mackay GM, Blyth MJ, Anthony I, Hopper GP, Ribbans WJ. A review of ligament augmentation with the InternalBrace™: the surgical principle is described for the lateral ankle ligament and ACL repair in particular, and a comprehensive review of other surgical applications and techniques is presented. Surg Technol Int. 2015;26:239-255.

3. Smith PA, Bley JA. Allograft anterior cruciate ligament reconstruction utilizing internal brace augmentation. Arthrosc Tech. 2016;5(5):e1143-e1147. doi:10.1016/j.eats.2016.06.007

4. Bachmaier S, Smith PA, Bley J, Wijdicks CA. Independent suture tape reinforcement of small and standard diameter grafts for anterior cruciate ligament reconstruction: a biomechanical full construct model. Arthroscopy. 2018;34(2):490-499. doi:10.1016/j.arthro.2017.10.037

5. Bedi A. Editorial commentary: buckle up surgeons: “safety belt” reinforcement of knee anterior cruciate ligament reconstruction grafts. Arthroscopy. 2018;34(2):500-501. doi:10.1016/j.arthro.2017.12.009

6. Arthrex, Inc. LA1-00086-EN_B. Naples, FL; 2018.

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.

View More

Educational Resources and Products

Knee Dislocation Case Using the InternalBrace™ Technique

Gordon Mackay, MD
Case Presentation Videos | 06:07 | English | 03/24/2023 | VID1-003283-en-US A

MCL Repair Using the InternalBrace™ Technique

Gordon Mackay, MD
Surgical Technique Videos | 06:52 | English | 01/10/2022 | VID1-0131-en-US B
Videos
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Surgical Technique Videos (4)

MCL Repair Using the InternalBrace™ Technique
MCL Repair Using the InternalBrace™ Technique
Gordon Mackay, MD
06:52 | English | 01/10/2022 | VID1-0131-en-US B
MCL Repair Using SutureTak® Anchors and the InternalBrace™ Technique
MCL Repair Using SutureTak® Anchors and the InternalBrace™ Technique
Michael J. Alaia, MD
04:44 | English | 10/28/2021 | VID1-00887-en-US C
InternalBrace™ Technique for Percutaneous MCL
InternalBrace™ Technique for Percutaneous MCL
Jim Bradley, MD
05:53 | English | 10/25/2021 | VID1-01251-en-US C
MCL Repair Using the InternalBrace™ Technique
MCL Repair Using the InternalBrace™ Technique
Christopher C. Dodson, MD
07:58 | English | 10/25/2021 | VID1-01012-en-US B

Case Presentation Videos (1)

Knee Dislocation Case Using the InternalBrace™ Technique
Knee Dislocation Case Using the InternalBrace™ Technique
Gordon Mackay, MD
06:07 | English | 03/24/2023 | VID1-003283-en-US A

Presentation Videos (2)

The Future is Now! The InternalBrace™ Technique
The Future is Now! The InternalBrace™ Technique
Michael G. Baraga, MD
08:14 | English | 10/14/2021 | VID1-002874-en-US A
InternalBrace™ Ligament Augmentation Changing Orthopedics
InternalBrace™ Ligament Augmentation Changing Orthopedics
Gordon Mackay, MD
24:49 | English | 03/29/2018 | VPT1-00776-EN C

Scientific Updates (1)

InternalBrace™ Technique: Knee Applications
InternalBrace™ Technique: Knee Applications
English | 06/03/2022 | DOC1-000161-en-US G

Video Series (1)

BreakThrough™ with Chris Adams, MD - Episode 4: InternalBrace™ for Sports Surgeons
BreakThrough™ with Chris Adams, MD - Episode 4: InternalBrace™ for Sports Surgeons
Christopher Adams, MD
29:13 | English | 05/02/2016 | VPT1-00642-EN A

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