The knotless anchor products are used in a variety of procedures in the shoulder (e.g.&nbsp;rotator cuff repair) as well as scapholunate repair and&nbsp;Ulnar Collateral Ligament repair. The unique PushLock design allows the surgeon to adjust the amount of tension on the tissue intraoperatively, allowing for precise tissue reduction. The tissue is securely held in a knotless fashion, allowing for soft tissue healing to bone. The anchor is available in bioabsorbable (PLLA), BioComposite and PEEK.

Foot and Ankle

Product

The DX 3.0 mm Knotless SutureTak® anchor for tensionable knotless soft-tissue repair provides the combined benefits of a proven biocomposite and reproducible suture anchor design and insertion procedure with knotless soft-tissue fixation. A tensionable, suture-locking mechanism allows users to control tension under direct visualization and to interconnect anchors for bridging techniques. The DX SutureTak anchor comes with the needle attached.

This animation demonstrates an all-knotless Brostrom repair using the DX 3.0 mm Knotless SutureTak® anchor and InternalBrace™ ligament augmentation technique highlighting the steps necessary for insertion and 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.

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Human

DX Knotless SutureTak® Anchor Repair

When using the Dex 3.2mm knotless SutureTak for ArthroBrostrom repair. The incision is made on the outside of the ankle over the torn ligament. Place the drill guide on the bone and drill using the 2.4mm. Drill. Remove the guide and then insert the Dex 3.0mm. Knotless SutureTak with gentle mallets until the laser line on the inserter is flush with the bone. Remove the suture and needles from the inserter handle and then remove the inserter. Check to make sure the anchor is securely set into the bone. Separate out the shuttle stitches from the blue working stitch, ensuring there are not any tangles or knots. Repeat the steps for the second anchor location. Introduce the seven millimeters talus offset guide into the sinus tarsi and flush against the talus. Drill with a 3.4mm drill bit and then tap with the The 4.75mm tap. Leaving the guide in place. Insert the 4.75mm swivel lock into the talus. Remove the inserter and the guide. Pass the needle from the blue working stitch from the 3.0mm. Knotless SutureTak through the ligament in a mattress fashion. Once the suture is passed, cut the needle off at the purple marking on the suture closest to the needle. Double over the blue working stitch through the loop end of the shuttling. Stitch at the purple marking and pinch and hold the sutures. Pull axially on the tape end of the shuttling stitch in line with the anchor, using short jigs until the blue working suture and shuttle loop are converted through the anchor. Place the foot in the desired position and continue to pull gently in an axial motion until the desired tension is met. Cut the suture and repeat for the second anchor. Place the drill guide for the 3.4mm. Drill on the fibula between the decks 3.0mm knotless, SutureTak and drill. Then tap using the 3.5mm. Tap. Remove the tap and guide. Load the FiberTape for the internal brace in the 3.5mm SwiveLock and place the eyelet at the FibuLock hole. Pulling the FiberTape taut. Use a marking pen to mark the FiberTape tail even with the laser marking on the inserter. Then pull the eyelet back on the FiberTape to the mark. Insert the 3.5mm SwiveLock and then cut the FiberTape flush to bone and the all knotless ligament repair is complete.

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DX 3.0 mm BioComposite Knotless SutureTak® Anchor

3.0 mm Knotless SutureTak®

Child (D)

The DX Knotless FiberTak® suture anchor provides the combined benefits of all-suture anchors with knotless soft-tissue fixation. A tensionable, suture-locking mechanism allows users to control the repair tension under direct visualization and the ability to interconnect anchors for bridging techniques. This anchor is ideal for small areas where minimal bone removal and knotless fixation are desired.

Richard J. de Asla, MD (Naples, FL), demonstrates an all-knotless lateral ankle instability live surgical procedure using DX Knotless FiberTak® anchors for the Brostrom repair and the InternalBrace™ 2.0 ligament augmentation repair system.&nbsp;
 
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.

Knotless Brostrom Lateral Ankle Repair With InternalBrace™ Repair and DX Knotless FiberTak® Anchors

We are here today to fix the anterior talofibular ligament using the all knotless lateral ankle instability system. For this case, we use the InternalBrace ligament augmentation procedure and Knotless FiberTaks. The system is a great option for patients with chronic ankle instability or lateral ankle laxity. Preoperatively. The patient has complained about ankle instability on physical exam. She demonstrated laxity on anterior drawer test. As you can see in the preoperative MRI, the imaging demonstrates injury to the atfl consistent with the patient's complaints. So without further ado, let's get in there. I positioned the patient in the supine position. And patients without perineal pathology, I prefer to make an incision anterior to the lateral malleolus. Initial dissection is through skin and subcutaneous tissue. And in patients with painful ankles. First scope the ankle joint looking for evidence of osteochondral lesions, loose bodies, or impinging lesions. In patients without perineal pathology. I prefer to make an incision anterior to the lateral malleolus. Initial dissection is through skin and subcutaneous tissue. The inferior extensor retinaculum is then mobilized for later repair. Drill the K-wires with a targeting sleeve in the guide into non-articular area of talus, and drill back into the body and parallel to the bottom of the foot. Confirm with fluoroscopy that your K-wires is in the correct position, both medial lateral and anterior posterior. Preparation of the talus is performed with a 3.4mm cannulated drill and a 4.75mm cannulated tap. Remove the K-wires and then gently mallet the 4.75mm SwiveLock through the guide until the anchor body is on bone, and then hold the paddle and turn the driver handle to lock in the collagen coated FiberTape into the talus. When the line in the window of the inserter meets the line on the outside of the inserter, the anchor is two millimeters countersunk in the talus. Place the FiberTape to the side and move your attention to preparing the fibula. Prep the fibula for the DX Knotless FiberTak. Anchors for a primary repair of the atfl. Drill one centimeter from the distal tip of the fibula with a 1.8mm K-wires. Implant the DX Knotless FiberTak. Anchor with gentle malleting until the driver is flush with the slotted drill guide. Do not advance the guide any further with the mallet as it could compromise the cortex. Unload the anchor driver and drill. Do not set the anchor. Repeat the steps for the second DX. Knotless FiberTak. Anchor 1 to 1.5 centimeters above and anterior to the first dx Knotless FiberTak anchor. Again, not setting the anchor in the center of the two broström anchors, but slightly more lateral than the anchors. Use a 3.4mm drill. Prepare for the 3.5mm. Biocomposite SwiveLock. Pass the needles from the DX Knotless FiberTak through the atfl in a mattress fashion and cut the needle off at the first purple marking closest to the needle, past the end of the working blue suture through the loop end of the shuttle white black suture and double it over at the second purple marking. Pinch and hold, then pull the tape end of the white black shuttling suture actually, and in line with the drill tunnel of the knotless FiberTak until tension is felt. Then use short, quick jigs to shuttle the stitch through the anchor. Make sure the foot is in the desired position, neutral dorsiflexion and maximum eversion, and then pull the knotless tension technology until the desired tension is met. Cut the sutures flush to set the position of the FiberTape. Place the foot in neutral or slight plantar flexion and mark the bottom laser line on the collagen coated FiberTape. Pull the eyelet back to the inside of the mark on the FiberTape and implant the 3.5mm SwiveLock, completing the InternalBrace ligament. Augmentation. Cut the remaining FiberTape. The inferior retinaculum is finally mobilized and sewn over the repair. As you saw in there, the DH Knotless FiberTaks, combined with the InternalBrace ligament augmentation procedure is perfect for surgeons who treat lateral ankle instability with an all knotless system. It's my preferred choice of fixation for all primary lateral ankle instability cases. This proven system gives me confidence to help my patients get back to life quicker, and I can confidently start the patient in accelerated rehabilitation much sooner with this method than previous methods. My post-op protocol is as follows. The patient is splinted for two weeks non-weight bearing at two weeks. The sutures are removed and the patient is made weight bearing and a protective boot at four weeks. The patient starts physical therapy and at six weeks we transition from a boot to an ankle brace. Thank you very much.

This animation demonstrates an all-knotless Brostrom repair using the DX Knotless FiberTak® anchor and InternalBrace™ ligament augmentation technique, highlighting the steps necessary for insertion and 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.

InternalBrace™ Repair With DX Knotless FiberTak® Anchors

When using the DD Nautilus FiberTak for ArthroBrostrom repair. The incision is made on the outside of the ankle over the torn ligament. Place the slotted guide on the bone and drill using the 1.8mm K-wires. Drill and cycle the drill. Keeping the guide in place and stable, insert the knotless FiberTak with gentle mallet until the inserter is flush with the guide. Undo the rubber O ring and remove the suture and needles from the inserter handle, and then remove the inserter and guide. Separate out the shuttle stitches from the blue working stitch, ensuring there are not any tangles or knots. Gently pull back on the blue working stitch, but only to make sure it is engaged in the bone. Do not fully set the anchor. Repeat the steps for the second anchor location. Introduce the seven millimeters talus offset guide into the sinus tarsi and flush against the talus. Drill with a 3.4mm drill bit It and then tap with the 4.75mm tap. Leaving the guide in place. Insert the 4.75mm SwiveLock into the talus. Remove the inserter and the guide. Pass the needle from the blue working stitch from the knotless FiberTak through the ligament in a mattress fashion. Once the suture is passed, cut the needle off at the purple marking on the suture closest to the needle. Double over the blue working stitch through the loop end of the shuttling. Stitch at the purple marking and pinch and hold the sutures. Pull axially on the tape end of the shuttling. Stitch in line with the anchor, using short jigs until the blue working suture and shuttle loop are converted through the anchor. Place the foot in the desired position and continue to pull gently in an axial motion until the desired tension is met. Cut the suture and repeat for the second anchor. Place the drill guide for the 3.4mm. Drill on the fibula between the dx knotless FiberTaks and drill. Then tap using the 3.5mm. Tap. Remove the tap and guide. Load the FiberTape for the internal brace in the 3.5mm. Swivel lock and place the eyelet at the fibular hole. Pulling the FiberTape taut. Use a marking pen to mark the FiberTape tail even with the laser marking on the inserter. Then pull the eyelet back on the FiberTape to the mark. Insert the 3.5mm swivel lock and then cut the FiberTape flush to bone and the all knotless ligament repair is complete.

DX Knotless FiberTak® Anchor

Orthobiologics

Trauma Upper Extremities

Trauma Lower Extremities

Arthrex Presents: Breakthroughs in Foot and Ankle Technology Winter 2022

DX Knotless FiberTak®

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.
References
1. Kulwin R, Watson TS, Rigby R, Coetzee JC, Vora A. Traditional modified Broström vs suture tape ligament augmentation [published online ahead of print, 2021 Jan 23]. Foot Ankle Int. 2021;1071100720976071. doi:10.1177/1071100720976071
 
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.

The InternalBrace™ ligament augmentation surgical technique is used to repair lateral or medial ankle instability. This innovative technique helps to support the primary ankle repair and prevent the possibility of secondary injury during the healing process.1,2&nbsp;
 
 
References
&nbsp;1. Coetzee JC, Ellington JK, Ronan JA, Stone RM. Functional results of open Broström ankle ligament repair augmented with a suture tape. Foot Ankle Int. 2018;39.107110071774236. doi:10.1177/1071100717742363&nbsp;
2. Viens NA, Wijdicks CA, Campbell KJ, Laprade RF, Clanton TO. Anterior talofibular ligament ruptures, part 1: biomechanical comparison of augmented Broström repair techniques with the intact anterior talofibular ligament. Am J Sports Med. 2014;42(2):405-411. doi:10.1177/0363546513510141&nbsp;
 
 
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™ Ligament Augmentation Repair

With the InternalBrace™ ligament augmentation 2.0 system, surgeons can now drill, tap, and implant through the talus offset guide. The system provides surgical versatility with added size and material options as well as a laser-line window to determine the SwiveLock® implant location. Cannulated drills and taps allow surgeons to adopt a percutaneous or minimally invasive approach. The biologic advantages of the collagen‐coated FiberTape® suture and JumpStart® antimicrobial dressing complete this comprehensive ligament augmentation system.
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™ 2.0 Ligament Augmentation Repair

InternalBrace™ Procedure for Brostrom Repair

Anish R. Kadakia, MD (Chicago, IL), presents the benefits of and clinical success using the InternalBrace™ ligament augmentation procedure and refutes competitive information.
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™ Ligament Augmentation Procedure: Clinical Success

Hello, my name is Anish Kadakia from Northwestern University and today we're going to discuss the internal brace ligament augmentation repair. My experience, some of the biomechanical and clinical data and discussion of some of the quote unquote, competition or competitors that are out there that are trying to mimic the excellent results that we're able to achieve. Let's look at some of the data about standard Atfl Brostrom reconstruction. What we know is that unprotected motion causes lengthening and failure of the reconstruction. So although we feel a taking the ligament, putting it back together and tightening it is okay. Unfortunately it is not. When you look at using suture anchors which are superior with regards to initial stability, they still do not provide enough rigidity for the repair for the long term. And this is just a biomechanical study showing how rigid and stable the internal brace is to stress. Why do I use the augmentation with the internal brace? Because it is better for the patient. Based on the data we have, early motion is critical. It's better for collagen. And the and the InternalBrace allows me to achieve that without lengthening. It's not just about the faster rehab that's kind of a short term goal. It's very important for our athletes, but for our non-athletes, the goal is that after a year, they're still stable. They don't have to come back and see you, and they're not getting that instability and that risk for arthritis. The InternalBrace allows reproducibility of the positive outcome. I've done over 200 procedures and I want to emphasize this not just for the lateral ankle. That's clearly where I started, but I use it all over the foot and ankle. And it's allowed me to do things I was unable to do without the internal brace. When you look at efficacy and safety, 1.5 million FiberTape bridging constructs have been used with really the best safety compatibility records in orthopedics, which is not the case for the competition. Collagen ingrowth is a very unique aspect of the internal brace because of the collagen coated FiberTape that we use. This is a case from a colleague of mine that had a large cavus deformity that underwent a reconstruction and unfortunately needed to be revised because of Subtalar instability, not because of the ankle joint and during his revision he noted peroneal tendon scarring, but also that the internal brace was completely coated with collagen. You can't even see the blue. So during his revision to do a non anatomical instability, he had to remove the collagen. Internalbrace is actually very hard for him to find. So you can see here as opposed to a synovitis reaction or a foreign body reaction, you actually have positive collagen ingrowth on the FiberTape. This is a white paper that we did kind of backing up the clinical data that we have the collagen coated FiberTape and a green identifies live tenocytes viability of Tenocytes. You can see the collagen coated FiberTape is superior to any of the competition. And red. If you look at the bottom two slides, red is actually tenocytes death. You look at live cell density on a graphical manner. You can see, statistically speaking, the collagen FiberTape is superior to all other products out there, and this is the only one that has collagen coating. What would be ideal for ligament augmentation? A native ligament is not a rubber band. And that seatbelt analogy actually is probably the best one. It is static. It's supposed to hold you in place while the native atfl doesn't really move. It's 0.4mm of excursion in a normal population with this particular ultrasonography study. And if you're symptomatic, you're unstable. 1.2mm of excursion causes you to have ankle instability. So we know AugMend should not have laxity or elasticity because that would make no sense. When you look at another study the data is reproducible for how much ligament has excursion. And the answer is it does not. The mean change in this ultrasound study was 0.1mm, and a symptomatic patient had 1.9mm, or almost two centimeters of laxity. We have a lot of studies to support the clinical efficacy of the internal brace. Multiple studies show that they have superior outcomes. Return to exercise is fast. And one thing that you'll notice is that there's not a lot of complications. If you look these studies up, they do not have product related complications. No studies without surgical complications, but it is not is not related to the product. So the internal brace ligament augmentation is safe. It's effective. It's better for the patients. This is a retrospective study that was done by Doctor Coetzee and his team. And you can see the mean return to sport was superior with the internal brace. This is a prospective randomized study by Doctor Colin Watson, Doctor Rigby Coetzee and Vora. This is the type of study that we want in orthopedics. It's very rare when you look at level one studies, 59 patients, standard brostrom with a suture anchor so appropriately done brostrom and those that had the primary repair augmented with the internal brace. When you look at early follow up return to sport, it was superior in patients that had the augmentation patients who were in the standard group. Some of them did not return to activity. And it's clearly more patients were unable to return to sport that did not have an augmentation. So in this prospective randomized study, the internal brace did better. Patients without the internal brace had to quit from the accelerated rehab. And there's just no question that the internal brace was superior. When you look at the at the competition per se, when you look at Ardalan. The argument that they use to promote their product is that it is elastic. It absorbs and rebounds. That's not my slide. That's their slide. Absorb and rebound would be the absolute opposite of what you would want in a ligament. Remember a ligament does not move it. Elasticity is only 0.1mm in the normal population. When you look at theirs at 125 newtons, which is about average for the amount of strain you would put on the atfl. They have 2.4cm of excursion. And that is clearly above and beyond someone who is symptomatic. So not only does it have elasticity, it is so elastic. It's actually worse than a patient that has ankle instability. This actually doesn't make any sense whatsoever when you talk about ligament reconstruction. When you look at the data in PubMed there's 121 articles when you type in the internal brace and you isolate that. And there's actually 153 for Ardalan. Well you may say, well look they have more studies. But it's not quantity. It's always about quality. So if you look at what they are published on you can see there's foreign body reactions, poor outcomes. With Ardalan. It's actually mostly quote unquote not ideal or bad data. This is a failed Achilles tendon rupture that was augmented with Ardalan. It's a standard Achilles rupture where we know that the mid substance SpeedBridge is phenomenal, does great minimal reaction. Patients have minimal scarring. And you can see here this patient has the opposite pain weakness. The Ardalan did not get absorbed. It was still present. And Doctor Ali is a very well respected surgeon who is a master of the Achilles tendon. This is another article looking at a systematic review of Ardalan. 11 articles for CMC arthritis where it was actually used initially. And so what were the areas of agreement? Now typically when you look at a systematic review, areas of agreement are positive things. There is nothing positive that they could possibly come up with. Ardalan is not recommended. High revision rate was noted in every article. Worse outcomes. Why would you use this type of a device? And we should just be aware that it's not helpful to the patient. There's another study prospective randomized study. And you may argue, well, they have a randomized study too. But what's the conclusion. Well swelling and pain was more common in Ardalan six required removal. And they had significantly better pain. But those that did not receive the Ardalan. Now they're trying to promote this for the foot and ankle. But when you look at the data, none of those are procedure specific. Those complications are body specific. The rejection rate, inflammation, worsening pain, that's not particular to the hand. That's just from the product itself. So they stayed here. Soft tissue reconstruction with Ardalan for multiple foot and ankle applications. And you may assume this is going to be 2030 50 procedures. Well let's look at the summary. Three cases. That's it. So they're using the word multiple in the most minimal way you can. It gets even better. So it causes foreign body reaction. This is a multiple published complication with Ardalan. Three cases of foreign body reaction specifically related to the implant itself. So physiologic body specific, not procedure specific. No surgeon would want this and no patient would want this if they knew the data anywhere near their ankle joint or anywhere in their body. If you're going to get a foreign body reaction, why would you put this in? The InternalBrace is superior for ligament augmentation, and is superior to any other product that tries to mimic the efficacy and the mechanics of the internal brace augmentation. We have multiple clinical articles showing both safety and efficacy, which nobody else does. Arthrex is the only company to have collagen coating to promote Tenocytes growth. Ardalan has proven foreign body reaction and is too elastic for ligament repair. The internal brace is biomechanically stable, promotes collagen growth, improves clinical outcomes and should be used in I use for all my ligament reconstruction. Thank you very much.

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Scientific Updates

InternalBrace™  Ligament Augmentation Technique (Ankle Instability) Scientific Update

InternalBrace™ Procedure for Brostrom Repair

Optimize tensioning and fixation without knot tying. The 2.9 mm PushLock suture anchor provides a secure means of knotless fixation in the hand and wrist, as well as the foot and ankle. Accommodating sutures ranging in size from 2-0 FiberWire® to 2.0 mm LabralTape™ sutures, this 2-piece anchor enables a no-profile repair that is quick and straightforward. The 2.9 mm BioComposite Knotless PushLock suture anchor uses a PEEK eyelet to place the sutures at the bottom of a drill hole, allowing precise tension and the ability to lock the sutures in place by impacting the body portion of the anchor.

Modified Brostrom-Gould Technique for Lateral Ankle Ligament Reconstruction

Hand and Wrist

Anchor Insertion

Anchor insertion. The FiberTak anchor offers a low profile, reliable fixation point for ligament and tendon repair, with less bone removal and maximum pull out strength. Utilizing the K-wires and drill guide, pre-drill the cortical bone to an automatic stop on the drill guide, keeping the drill guide in place. Insert the FiberTak anchor and gently impact it until the handle is flush with the drill guide. After insertion, pull back the anchor inserter while holding counter pressure on the guide to bone. Next, remove the needles, rubber stopper, inserter and drill guide for final seating of the anchor. Pull the sutures back. This firmly sets the anchor in the bone. Reattach the tissue to the repair site with a SutureTape and secure for final fixation. The Biocomposite SutureTak anchor features a unique molded in suture eyelet that maintains its strength throughout most of the degradation cycle and eliminates suture abrasion during knot tying. The drill hole is prepared utilizing the appropriate drill guide. The anchor is introduced into the hole and the SutureTak anchor is advanced into the bone socket. Release the FiberWire sutures from the driver and remove the handle from the anchor. Reattach the tendon to the repair site with the FiberWire and secure with knots. The SwiveLock anchor offers a fully threaded knotless anchor design that provides maximum pull out and insertion strength while saving time. The drill hole is prepared utilizing the appropriate drill guide. The tendon is whip stitched with FiberLoop suture, and the suture is then loaded into the anchor eyelet. The eyelet, FiberLoop, and tendon are delivered into the bone socket while holding the thumb pad. Static. Twist the knob of the SwiveLock inserter to advance the anchor into the bone. The remaining sutures can be cut flush for a no profile repair. The 2.5mm mini PushLock offers a no profile Knotless TensionLoc suture repair. The drill hole is prepared utilizing the appropriate drill guide. Utilizing a suture first technique to capture the appropriate amount of tendon or ligament with FiberWire suture. The FiberWire suture is then loaded into the anchor eyelet and delivered into the bone socket. The construct is then locked into position by advancing the mini PushLock anchor body, creating a strong no profile knotless repair. The Corkscrew ft is a fully threaded titanium anchor that provides maximum fixation strength and simple insertion utilizing the included K-wires. Pre-drill the cortical bone to guide insertion. Thread the anchor into the bone tunnel until it is flush with the bone surface. Release the FiberWire suture and remove the handle from the anchor. Re approximate the tissue to the repair site with a FiberWire and secure for final fixation.

PushLock® Anchors

The 4.75 mm DX Knotless SwiveLock® anchors for soft-tissue repair provide surgeons the added benefit of a knotless repair retention suture feature. Continuing innovations that enhance the repair options using the versatile SwiveLock anchor are what make it the leading anchor on the market.
<ul>
 <li>Tensionable knotless technology</li>
 <li>Collagen-coated FiberTape® suture</li>
 <li>Free needle included</li>
 <li>Laser-line window indicates when anchor is flush and 2 mm countersunk</li>
 <li>Radiopaque shoulder and marker for anchor placement under fluoroscopy</li>
</ul>

Shoulder

The SwiveLock® suture anchor is the most trusted and versatile soft tissue-to-bone fixation system available. With more than 8 million anchors implanted,1 multiple clinical studies support its use for applications throughout the body.2,3
References
1. Arthrex, Inc. Data on file (Sales as of June 3, 2020). Naples, FL; 2020.
2. Arthrex, Inc. CC1-00019-EN_E. Naples, FL; 2018.
3. Arthrex, Inc. LA1-00038-EN_B. Naples, FL; 2017.

Knotless Suture Anchors

3.0 mm Knotless SutureTak^®

DX Knotless FiberTak^®

InternalBrace™ Procedure for Brostrom Repair

PushLock^® Anchors

SwiveLock^® Anchors

Knotless Suture Anchors

3.0 mm Knotless SutureTak®

DX Knotless FiberTak®

InternalBrace™ Procedure for Brostrom Repair

PushLock® Anchors

SwiveLock® Anchors

3.0 mm Knotless SutureTak^®

DX Knotless FiberTak^®

PushLock^® Anchors

SwiveLock^® Anchors