Arthrex offers the most comprehensive selection of ACL/PCL instruments currently available. Unique design and precision manufacturing of Arthrex instruments facilitate reproducible techniques that help surgeons carry out anatomic, less invasive and biomechanically sound ACL/PCL reconstructions.&nbsp; &nbsp;

Knee

Product

Many products are available to assist the surgeon with bone-tendon-bone (BTB) graft harvesting and preparation. 

 
 
The parallel graft knife—with parallel blades to create a precise cut in a single pass—is designed for harvesting the patellar or quadriceps tendon during an ACL or a PCL reconstruction. 
 

 
Graft harvesting cutting guides and saw blades can harvest an ideal trapezoidal-shaped bone plug with predrilled suture holes from both the patella and the tibia; the cutting guides provide consistent, reproducible 
results during tendon harvest. 
 

 
Additional instrumentation for BTB graft preparation, including a graft harvesting osteotome and ACL graft shaper, are also available.&nbsp;

BTB Graft Harvest and Preparation Instruments

Arthrex® Graft Tubes are full circumference, full length, clear tubes that facilitate graft compression, sizing and preparation. The unique transparent tubes with an etched ruler allow visualization of the graft during diameter and length sizing. Funneled entrance and attachable handle ease the entry of grafts into the sizer, allowing compression of up to 2 mm. Small holes in the Graft Tubes allow hydration of the graft along the entire length. The tapered tip allows delivery of the graft directly into the tibial tunnel or medial portal.

Graft Tubes Set

The Hamstring Donor Site Delivery Tube allows a surgeon to directly administer an anesthetic after autograft hamstring harvest during ACL reconstruction. The overall length of the tube is 247 mm. The distal 90 mm features 16 fenestrations in an offset pattern to deliver the anesthetic effectively over a wide area.

Hamstring Donor Site Delivery Tube

Arthrex offers the most advanced techniques and instruments for hamstring harvesting and preparation. Harvesting can be accomplished safely and reproducibly both from the traditional anterior approach or through a posterior approach using the minimally invasive hamstring harvest technique and specialized tendon strippers. 
 

The Arthrex Graft Prep Station offers a variety of interchangeable clamps and posts to facilitate graft tensioning and suturing. 
 

Graft preparation has been revolutionized with the FiberLoop® line of suture and SpeedWhip™ technique. The continuous loops of #2 or #0 suture and free-floating straight or curved needles allow reproducible graft suturing in half the time of traditional straight sutures.

Hamstring Graft Harvest and Preparation Instruments

Arthrex pioneered quadriceps tendon (QT) autograft harvesting in 2014 with the minimally invasive QT harvest instrument set, which was designed for a much easier and more reproducible QT harvest. The next evolution in graft harvesting for ACL reconstruction, the QuadPro™ tendon harvester was specifically engineered to allow for efficient, safe graft harvesting while reducing the morbidity and challenges associated with traditional quad harvesting techniques.

Quad Tendon Harvest and Preparation

The QuadPro tendon harvester is a next-generation harvesting device designed to safely, easily, and quickly harvest a quadriceps autograft using a minimally invasive technique. The handle has been ergonomically designed to visualize approximate graft length during harvesting. The QuadPro tendon harvester is available in four sizes (8 mm to 11 mm) to accommodate each patient’s unique needs as well as the surgeon’s preference for graft size.

QuadPro™ Tendon Harvester

Decades of graft preparation experience and feedback from surgical teams have culminated in the&nbsp;GraftPro&nbsp;graft preparation system. The&nbsp;GraftPro system has numerous features that simplify and accelerate graft preparation of soft-tissue, BTB, QuadLink™, and GraftLink® grafts.

GraftPro™ Graft Preparation System 

Graft Harvest and Preparation

Arthrex offers a complete line of graft harvesting and preparation instruments for hamstring, patella tendon and quadriceps tendon. Arthrex has developed unique tools and techniques to increase reproducibility of graft harvesting while decreasing morbidity through minimally invasive techniques that can be performed through a small incision.

Secondary (C)

The ACL ToolBox was designed to fit the needs of modern ACL reconstructions. The streamlined three layer case contains all the reusable instruments needed to complete the majority of common ACL procedures and contains an additional "pin mat" area for customization. The ACL ToolBox now contains the RetroConstruction™ Guide System with commonly used ACL marking hooks such as the footprint guides for femoral ACL drilling. Variable drill sleeves are included for all techniques and can be used with standard 2.4 mm pins, 3.0 mm RetroDrill® Pins and the 3.5 mm FlipCutters®. Everything needed to complete an ACL reconstruction can be found in this case including graft harvesting, notch preparation, tunnel drilling, graft passing and fixation.

ACL ToolBox

The ACL/PCL Cortical Fixation Case is a system that incorporates a variety of fixation options. The set includes low-profile 4.5 mm cortical, 6.5 mm cortical, and 6.5 mm cancellous screw options. It also includes low-profile spiked washers and ligament staples. The screws have extremely low profile heads to reduce soft tissue irritation. A step drill with laser depth marking countersinks the screw head flush to bone when used as a suture fixation post. The smooth shank with suture groove orients the sutures safely under the head during screw insertion. The optional, low profile spiked washer may be used in conjunction with the cancellous screw for fixation of soft tissue or tendons directly to bone. The instrumentation set includes a 2.5 mm Drill for Bi-Cortical Post to broach the cortical bone, while the depth device is used to obtain accurate sizing information. Although the post has a self-tapping feature, a tap is included for those who prefer the “drill-measure-tap” insertion technique. Ligament staples, with a low profile bridge, reduce the frequency of secondary removal due to patient discomfort caused by soft tissue irritation. The cobalt chrome spiked fixation staple has sharp leg points for easier penetration into cortical bone without predrilling. The Staple Driver with attachable impactor/extractor allows complete impaction since the staple driver tip is flush with the staple bridge. The Staple Seating Punch may be used for further impaction. All staples are 20 mm in length.

ACL/PCL Cortical Fixation Instrument Set

Multiple collateral ligament reconstruction techniques are available and range from aperture fixation using the BioComposite SwiveLock® tenodesis system with biocomposite interference screws to suspensory fixation using TightRope® technology. 
 
For primary or hybrid collateral ligament repair techniques, choose from a comprehensive line of anchor fixation devices, including FiberTak® soft anchors or biocomposite suture anchors, which come preloaded with needles.

Collateral Ligament Reconstruction Set

The MCL InternalBrace procedure consists of a 2 mm-wide FiberTape® suture that spans the distance between two Knotless SwiveLock® anchors to augment, or enhance, the fixation points of the primary MCL repair by expanding the area of approximation during the healing process. FiberTape sutures have been proven safe and effective with over 15 years’ experience and over 3.8 million uses, including tendon and ligament-bridging repairs.
InternalBrace surgical technique is intended only to support the primary repair and is not intended as a replacement for the standard of care using biologic augmentation in a primary repair. InternalBrace surgical technique is intended only for soft-tissue-to-bone fixation and is not cleared for bone-to-bone fixation.

InternalBrace™ Procedure For A Medial Collateral Ligament (MCL) Repair

The streamlined PCL ToolBox contains all the necessary instruments for performing a variety of modern PCL reconstruction techniques. The set includes the RetroConstruction™ Drill Guide System with drill sleeves for use with the FlipCutter® reamer, RetroDrill® reamer, and standard 2.4 mm guide pins.
 
 
Femoral and tibial RetroConstruction marking hooks allow safe, reproducible placement of pins and drills into the anatomic footprints. Also included in the set are double-bundle femoral drill guides, curved instruments for tibial preparation, a knee obturator for safe and easy posterior portal placement, tunnel plugs, drills, screwdrivers, notchers, and other accessories. This toolbox facilitates standard transtibial PCL reconstruction as well as modern techniques such as the arthroscopic inlay and GraftLink® all-inside PCL technique.

PCL ToolBox

The RetroConstruction™ drill guide set provides surgeons 6 different marking hook options for multiple applications all in a small, easy-to-manage set. The adjustable C-ring allows several drilling angles without sacrificing accuracy. Multiple drill sleeves accommodate retrograde reaming with the FlipCutter® drill or standard 2.4 mm pins for antegrade reaming. The additional stepped drill sleeve acts as a depth stop for retrograde drilling and allows continued access to the joint for graft passing suture insertion after FlipCutter drill removal.

RetroConstruction™ Drill Guide System Instrument Set

The SlapDriver interference screwdriver family was designed to combine the technology and reliability of the hexalobe, trilobe, and quick connect ratcheting screwdrivers with the convenience of a built-in slap hammer mechanism to make driver removal easier and faster.

SlapDriver

Instrument Sets

Arthrex Instrument Sets are developed to be the most comprehensive sets available to help overcome the challenges intraoperatively of ACL and PCL reconstruction. The ACL Cruciate ToolBox and PCL Cruciate ToolBox are extremely comprehensive systems and contain everything needed for ACL or PCL reconstruction. The RetroConstruction Drill Guide System Instrument Set provides surgeons six different marking hook options for multiple indications all in one, small, easy to manage set.

The Clear Open Cannulas, with detachable handle option, facilitate instrument introduction by allowing the user to freely see the instruments entering the joint, while providing an unrestrained field of view. Manufactured from a shatterproof polycarbonate material, these strong cannulas resist bending. The tapered and blunt tips may eliminate iatrogenic cartilage or tissue damage during instrument insertion. Each can be used with a variety of quick connect handles that can be removed while the cannula is still in place. The Clear Open Cannula, used in conjunction with the AR-2001 Tear Drop Handle, is the perfect option for atraumatic instrument introduction and removal from the joint.

Clear Open Cannulas

The Knee Obturator has been specially designed to simplify the location and creation of posterior knee portals as well as introduction of a working cannula. Posterior portals are often necessary for several common procedures such as; loose body removal, PCL reconstruction, meniscal root avulsion repair, and popliteal cyst debridement. Current “outside-in” techniques can be time consuming and put posterior structures at risk of damage with sharp spinal needles and scalpels. The Knee Obturator lets surgeons quickly create the portal from the inside-out. The unique curvature fits around the cruciate ligaments and around the back of the femoral condyles. The tapered eyelet tip facilitates insertion of a PassPort Button Cannula with a traction suture or acts as a switching stick for cannula insertion.

Knee Obturator for Posterior Portals

The PassPort Button™ Cannula help maximize visibility and maneuverability inside and outside of the arthroscopic work space. The double-dam one-piece molded design has low-profile flanges that seat flush to the skin and soft tissue. These flanges create a stable portal that allows instruments to be inserted and removed, without the concern of cannula loss.

PassPort Button™ Cannula

The Shoehorn Cannula has a longitudinal slot on top of the cannula to allow oversized instruments to be introduced. Each cannula is supplied with a disposable obturator.

Shoehorn Cannula

The translucent Twist-In Cannula allows direct arthroscopic visualization of instruments through the cannula. The flexible option easily conforms to large or curved instruments. Each cannula is supplied with a “No-Squirt” Cap and disposable obturator. The threaded design greatly inhibits cannula “fall-out” during instrument removal and allows for capsule retraction for visualization. The side port may be used for irrigation inflow or passive outflow.

Twist-In™ Cannula

Portal Creation and Cannulas

Arthrex offers a variety of innovative plastic and flexible silicone cannulas with multiple sizes and retaining options. The majority of the plastic cannulas are translucent for arthroscopy to allow surgeons to visualize instrumentation and sutures passing through the cannula. The new PassPort Cannulas offer a double-dam, one-piece molded design with low profile flanges that seat flush to the skin and underlying soft tissue.

The Coring Reamer System is designed to harvest a cylinder of cancellous bone while simultaneously creating the tibial tunnel. The harvested bone core can then be used to fill the patellar tendon harvest site, pack into bone tunnels construct a bone-hamstring tendon-bone autograft, or bone graft opening wedge HTO procedures. The distal tunnel should be drilled up to a depth of 10 mm, with a cannulated drill that is 1 mm larger in diameter than the selected Coring Reamer, prior to collared pin insertion. The pin positioner facilitates simplified guide pin/collared pin exchange. The Coring Reamer is then drilled over the collared pin for directional control and subsequent bone core removal. The Coring Reamer is also available in 13 mm and 14 mm diameters for “retightening” of an intact ACL graft which is executed by cutting around the tibial insertion of the graft. The tibial bone core is pulled distally and secured with an interference screw.

Disposable Coring Reamers

The Arthrex Flexible Reamer System facilitates reproducible femoral socket creation from the medial portal without hyperflexion of the knee. An innovative, flexible link design allows unmatched flexibility. The adjustable curved guide, flexible guide pins, and screwdrivers give surgeons more versatility in socket placement options for graft fixation. Sterility is never guaranteed. We sterilize to an SAL of 10^-6

Flexible Reamers

Low-profile reamers facilitate femoral socket preparation through the medial portal and also allow greater flexibility in femoral socket placement for transtibial procedures. The reamer's extra thin shaft and “2-flute” design provide a flat profile that easily passes through the portal and avoids damaging the femoral condyle and PCL. The reduced length of the flutes allows the drill to spin without contacting PCL fibers. Low-profile reamers may be used with the Arthrex Transportal ACL Guides for anatomic guide pin placement through the medial portal.

Low Profile Reamers

Full thickness cannulated drills, with calibrated depth marks, are designed specially for ACL tibial tunnels, PCL tibial and femoral tunnels and standard two-incision ACL reconstruction procedures. For customers who prefer one-time-use instrumentation, Arthrex® offers full thickness, cannulated drills that are packed sterile.

Sterile Cannulated Reamers

Reamers

Arthrex offers a variety of reamers for various techniques and surgicalapproaches. Unique design and superiormanufacturing allows reproducible creation of quality tunnels and sockets forall reconstruction techniques. Arthrex’sinnovative reamers also facilitate the most least invasive techniques currentlyavailable.

The new, innovative FlipCutter III drill is an adjustable, variable-size, all-in-one guide pin and reamer that allows minimally invasive socket creation from the inside out. Proprietary technology gives the FlipCutter drill unconstrained freedom of socket positioning and is ideal for difficult-to-reach applications such as tibial socket creation for PCL reconstruction, anatomic femoral socket creation for ACL reconstruction, and socket creation for meniscal allograft transplantation or meniscal root repair. With an adjustable design, the FlipCutter III drill can accommodate sizes 6 mm to 12 mm, including half sizes.

FlipCutter® III Drill

RetroConstruction

Retrograde drilling utilizing RetroConstruction instrumentation gives surgeons the ability to precisely place femoral and tibial sockets/tunnels without the constraints of standard outside in drills.&nbsp; RetroConstruction also has been shown to create better quality tunnels without intrarticular fracturing and allow for the creation of sockets instead of full tunnels for less invasive techniques.&nbsp;&nbsp; Arthrex offers a full line of anatomic drill guides for multiple indications that are compatible with RetroDrill and FlipCutter that allows surgeons to perform the most advanced reconstruction techniques currently available.

Knee Ligament Reconstruction Instruments

Graft Harvest and Preparation

Instrument Sets

Portal Creation and Cannulas

Reamers

RetroConstruction