Knee

Procedure

Product

Available in five anchor configurations, each Knee FiberTak anchor has unique features optimized for treating pathology around the knee, including a redesigned, softer anchor body for reliable deployment in hard bone and vibrant new SutureTape colors for easier visualization and suture management in an open surgical environment. The anchor inserter and hole-prep instrumentation have a shorter working length, allowing for more ergonomic anchor insertion much closer to the anatomy.&nbsp;
Additionally, the instrumentation is available as a disposable kit or as a reusable guide, drill, and punch. The anchors can be inserted either in a drill hole, a pilot hole using the punch, or even self-punched in the appropriate bone density.
A variety of implants address various pathology and surgeon preferences:
<ul>
 <li>Double Knotless Anchor: Features 2 preconverted knotless tensionable loops of 1.3 mm SutureTape loops; great for LET and ALL fixation&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</li>
 <li>Hybrid Anchor: Includes 1 preconverted tensionable knotless SutureTape loop and a sliding 1.3 mm SutureTape with swaged-on needles; perfect for onlay MPFL reconstruction</li>
 <li>Double Knotted Anchor: Features 2 sliding 1.3 mm SutureTapes with swaged-on needles; a great option for any application that requires knots</li>
 <li>InternalBrace™ Technique Anchor: Features 1 sliding 1.3 mm SutureTape with swaged-on needles and a low-profile 1.7 mm FiberTape® loop swaged to a single tail for easy passage and loading; revolutionary for collateral repair using the InternalBrace technique</li>
 <li>Button Anchor: Features 2 passing links for fixation of independent tension-slide constructs; an excellent option for MCL and LCL tension slide</li>
</ul>
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.

Knee FiberTak® Anchor

The SwiveLock fixation kit includes the implants and instruments needed to back up the fixation sutures of an ACL graft or FiberTape® suture for the InternalBrace™ technique in an ACL reconstruction or primary repair. The kit contains a 4.75 mm SwiveLock implant as well as a spade-tipped drill and two sizes of disposable taps (4.75 mm and 5.2 mm). Because successful ACL reconstruction requires strong tibial fixation, this system provides a reliable and reproducible augment to ACL tibial fixation.
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.

SwiveLock® Fixation Kit

Ruptures of the quadriceps and patellar tendons are common in elite and recreational athletes. Most surgeons treat these injuries surgically to lessen the risk of long-term disability and morbidity. Historically, open techniques have been used for rupture repairs but may be complicated by wound-healing issues and infection. The minimally invasive Percutaneous Achilles Repair System (PARS) technique can be used to treat quadriceps, patellar, and Achilles tendon ruptures.
The PARS system helps facilitate consistently reliable capture of the distal aspect of the quadriceps tendon and includes color-coded FiberWire® and FiberTape® sutures. The anatomically contoured guide is reusable, while the suture and passing needles come packaged in a convenient kit. The PARS system provides the option of using transverse or locking sutures, or both. The colored FiberWire sutures offer a more organized approach to identifying and securing matched pairs.

Quad Tendon Repair with PARS System 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&nbsp;
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&nbsp;
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&nbsp;
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&nbsp;
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&nbsp;
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.

InternalBrace™ Technique

Lateral extra-articular augmentation or reconstruction aims to eliminate residual laxity and reduce the risk of ACL graft rupture. Anterolateral ligament reconstruction could play a role in augmenting rotational stability in the ACL-reconstructed knee and is most likely to benefit hyperlax patients, revision cases, pivoting athletes, and those with IKDC grade III pivot shifts.

Anterolateral Ligament Augmentation

Ruptures of the quadriceps and patellar tendons are common in elite and recreational athletes. Most surgeons treat these injuries surgically to lessen the risk of long-term disability and morbidity. Historically, open techniques have been used for rupture repairs, but these techniques may be complicated by wound-healing issues and infection. The minimally invasive Percutaneous Achilles Repair System (PARS) technique can be used to treat quadriceps, patellar, and Achilles tendon ruptures.

Patellar Tendon Repair

Tendon and Ligament Repair

Secondary (C)

The anatomic double-bundle technique replicates the native shape of the medial patellofemoral ligament (MPFL), provides stability in both flexion and extension, and effectively limits rotation throughout ROM, helping minimize postoperative instability. The technique, if accomplished directly and anatomically, can also allow for more aggressive rehabilitation protocols and earlier return to activity.1
Successful MPFL reconstruction is dependent on anatomic placement of the graft. The technique incorporates the use of a femoral template to ensure proper placement of the graft in the femur. This position provides a static fixation point that equalizes the tension across the graft in flexion and extension, thus helping minimize stress across the patellofemoral joint.
Other options include Knee FiberTak® anchors for onlay MPFL techniques as well as 4 MPFL convenience packs to address each patient's unique needs and each surgeon's fixation preference. The newest kits use 3.9 mm BioComposite SwiveLock® anchors for patellar fixation and either a 6 mm × 20 mm BioComposite FastThread™ interference screw or an ACL TightRope® implant for femoral fixation.
Reference
1. Schöttle PB, Hensler D, Imhoff AB. Anatomical double-bundle MPFL reconstruction with an aperture fixation. Knee Surg Sports Traumatol Arthrosc. 2010;18(2):147-151. doi:10.1007/s00167-009-0868-z

MPFL Reconstruction

Patients with patellar instability suffer from recurrent patellar dislocations and are limited in their performance of activities of daily life.
In order to create congruent bony anatomy, the sulcus deepening trochleoplasty procedure helps patients get back to daily living activities.
Deepening trochleoplasty demands precise surgical skills and customized technical solutions for each individual patient and indication. The new Arthrex Trochlea Guide System enhances reproducible cartilage preparation, with 3 mm and 5 mm Offset Aiming Guides and effective, solid bone modelation with the dedicated 2.9 mm Burr. In conjunction with Arthrex PushLock® or SwiveLock® anchor fixations, this technique offers a solution for an anatomic trochlea recreation.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

Trochleoplasty

Anteromedialization (AMZ) procedures have been well documented as an effective treatment option for the correction of patellofemoral malalignment and to unload the lateral patellar facet in deep flexion. The comprehensive T3 AMZ System is designed to achieve precise cutting angles during tibial tuberosity AMZ osteotomy procedures to accurately realign the extensor mechanisms and unload the patellofemoral joint. 
 

Benefits:
<ul>
 <li>Precise, instrumented osteotomy through anatomically referenced cuts</li>
 <li>Fixed angle (45˚, 60˚, and 90˚) cutting guides provide accurate, reproducible control of relative anteriorization and medialization based on chosen angle</li>
 <li>Included soft-tissue retractor protects vital posterior structures 
</li>
</ul>

T3 AMZ System for Tibial Tuberosity 

Patellofemoral Realignment and Reconstruction

Anteromedialization procedures have been well documented as an effective treatment option for the correction of patellofemoral malalignment and to unload the lateral patellar facet in deep flexion.

Soft Tissue Repair

Tendon and Ligament Repair

Patellofemoral Realignment and Reconstruction